STAMP: components of observable behaviour that indicate potential for patient violence in emergency departments

AIM: This paper is the report of a study to explicate the components of observable behaviour that indicate a potential for violence in patients, their family and friends when presenting at an emergency department. BACKGROUND: Violence towards nurses is a contemporary, multifaceted problem for the healthcare workforce globally. International literature identifies emergency departments as having high levels of violence. METHOD: A mixed method case study design was adopted, and data were collected by means of 290 hours of participant observation, 16 semi-structured interviews and 13 informal field interviews over a 5-month period in 2005. Thematic analysis of textual data was undertaken using NVivo2. Frequency counts were developed from the numerical data. FINDINGS: Five distinctive elements of observable behaviour indicating potential for violence in patients, their families and friends were identified. These elements can be conceptualized as a potential nursing violence assessment framework and described through the acronym STAMP: Staring and eye contact, Tone and volume of voice, Anxiety, Mumbling and Pacing. CONCLUSION: Staring and eye contact, Tone and volume of voice, Anxiety, Mumbling and Pacing provides a useful, practical nursing violence assessment framework to assist nurses to quickly identify patients, families and friends who have a potential for violence.