Antisocial Behavior on Healthcare Professionals in an Emergency Unit.

Study Overview
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Brief Summary
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At the hospital, the attacks against health professionals are becoming commonplace, making working conditions difficult. The ophthalmological emergencies are a perfect testing ground to evaluate the effectiveness of a series of original actions to prevent the occurrence of violence against healthcare workers. The main objective is to measure the impact of an integrated prevention of the occurrence of antisocial behavior or attacks against the healthcare workers. The prevention program combines five interventions (steps): 1) a computer sorting algorithm and specific screens for calling patients in waiting rooms, 2) a clear signage to direct patients between waiting rooms, treatment rooms and administrative et medical offices, 3) Posts information on the activity of emergency services displayed on screens, in the waiting rooms, 4) a mediator/go-between/conciliator, 5) and a dummy surveillance camera. This is an interrupted time series study. All patients admitted to the ophthalmological emergency unit of a university hospital located in Lyon, France, are included in the study, from June 2013 to Sept 2015

Official Title
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Impact of a Program to Prevent the Risk of Antisocial Behavior and Attacks of Patients or Attendant on Healthcare Workers in an Ophthalmic Emergency Unit.

Conditions
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Rudeness/Incivility, Aggression or Violence Against Healthcare Workers in an Ophthalmic Emergencies Unit.

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient admitted to the ophthalmologic emergency unit No Exclusion Criteria
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| All patients admitted to the ophthalmologic emergency unit.<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of patients (or their attendants) who committed a rudeness/incivility or aggression or violence against healthcare workers. | When seeking to characterize the violent behavior, three levels of increasing aggressiveness are typically distinguished: a) incivility i.e. the lack of respect for others characterized by relatively mild acts, b) physical or verbal aggression (insults, threats, assault), and c) the violent act. | Patients will be followed for the duration of the ophthalmic emergency unit stay, an expected average of 2 hours. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Occurrence of antisocial behavior or assaults against other patients or carers attending the ophthalmological emergencies. | Proportion of incivility or assaults against other patients or attendant present (number of incivility or assaults on the number of patients admitted to the emergency) | Patients will be followed for the duration of the ophthalmic emergency unit stay, an expected average of 2 hours. | 
| Waiting times for patients | Average waiting times for patients with ophthalmic emergencies before they were taken care of by a doctor. | Patients will be followed for the duration of the ophthalmic emergency unit stay, an expected average of 2 hours. | 
| Stress of healthcare personnel | Stress at work of health personnel engaged in an ophthalmic emergency unit measured by the Karasek questionnaire. 30 mn are necessary to complete the questionnaire. | 30 minutes | 
| Satisfaction of patients |  | Patients will be followed for the duration of the ophthalmic emergency unit stay, an expected average of 2 hours. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Incivility, Rudeness, Aggression, Violent act, Healthcare workers, Emergency unit