Recording violent incidents in the emergency department

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To evaluate the quality of record-keeping by nursing staff after violent incidents in one emergency department in the UK.


This study was undertaken between August 2007 and May 2009 in the emergency department of one acute NHS hospital. A retrospective documentary analysis of violent incident forms completed by nursing staff (n = 38), semi-structured interviews (n = 9) and periods of non-participatory, unstructured general observation (52 hours) was conducted.


From the documentary analysis, 25 incident forms (n = 38, 66%) were incomplete or lacking detail. Semi-structured interviews with study participants suggested that many violent incidents went unreported. It was widely accepted by the participants that the reporting process did not capture the reality of clinical practice, and the lack of a robust reporting process suggested that incident reporting was seen as a low priority.


This study's findings support those of previous studies examining the quality of record-keeping in clinical practice. Poor record-keeping is a common breach of the Nursing and Midwifery Council code of conduct, potentially compromising patient safety. Strategies need to be formulated to improve record-keeping. Avoiding individual blame and consideration of the working environment may encourage staff to complete incident forms.


Terence Ferns


Senior lecturer, Department of Acute and Continuing Care, School of Health and Social Care, University of Greenwich, London. Correspondence to:


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