Use of the Brøset Violence Checklist and Reduction of Workplace Violence in Emergency Departments

Nurses in emergency departments continue to experience workplace violence despite many preventive practices, such as using workplace violence training and security officers. The CDC states between 35-80% of hospital staff have been assaulted at least once in their careers (2020). This project proposal explores the use of the Brøset Violence Checklist (BVC) and its efficacy in emergency department nursing practice to further the understanding of workplace violence and recognize a potential solution. The BVC is a six-item checklist that screens for potentially violent patients. The criteria assessed for each patient is if they are confused, irritable, boisterous, a physical threat, a verbal threat, or if they attack objects. These are then added together to establish a score. A score of one or two indicates a moderate risk for violence. A score of three or more indicates a high risk for violence and requires immediate preventive measures. For this proposal, research was conducted through EBSCO and PubMed. Previous studies showed that the BVC effectively recognizes violent patients and is a potential solution to reducing workplace violence. The method proposed is to implement the BVC into a triage checklist for every patient upon emergency room entry. While the patient gets an initial set of vitals and provides information about their presenting problem, the nurse will use the BVC to assess the patient’s behavior. If a patient has a BVC score of one or more, the nurse will notify nursing staff and security, and the patient chart will be flagged. This study proposal will compare rates of unexpected violent events before implementing the checklist to the rates of incidents while using the checklist. The expected outcome would be a decrease in workplace violence. Keywords: workplace violence, occupational violence, Brøset Violence Checklist, BV