P-224 Impact of the Presence of a Mediator in Emergency Departments on Patient Violent Behaviours Against Healthcare Workers

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Introduction Considering violent behaviors from patients towards healthcare workers (HCW) in emergency departments (EDs), we evaluated the impact of mediators in EDs on violent behaviors perpetrated by patients or their relatives against HCW and on HCW well-being at work. Methods A randomized trial was performed in 4 French EDs during 12 months. EDs’HCW, patients aged ≥18 and their relatives were included. Four mediators worked alternately in the EDs. The main outcome was the rate of ED visits with at least one act of violence carried out by a patient or relatives declared by HCW. HCW well-being was measured with the Work-Related Quality of Life (WRQoL) scale. Results 50,429 ED visits were assigned to the mediator intervention group (IG) and 50,851 to the control group (CG). Mediators reported 1,365 actions (e.g. response to a request for information on the clinical management or waiting time). The rate of ED visits with at least one act of violence was 0.26% in the IG and 0.21% in the CG (OR=1.23; 95%CI [0.73; 2.09]). WRQoL was analyzed for 102 HCW in IG and 125 in CG. The mean (range) overall WRQoL score was 2.9 (1.2-4.8) for the pre-mediator intervention survey and 2.9 (1.2-4.2) for the post-mediator intervention survey. The adjusted mean difference of the overall WRQol was -0.03 (95%CI [-0.20; 0.13]). Discussion Interventions by mediators did not affect violent behavior or on HCW well-being, but highlighted a major need for communication between patients and HCW. Conclusion Research studies targeting communication with patients are needed to reduce violence in EDs.