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Nurses back plans to design out A&E violence

Nurses have backed a government project that has recommended simple changes to the design of accident and emergency departments to help reduce violence levels towards staff.

Three trusts have been working with the Design Council on a project to investigate the causes of violence and aggression in A&E – the latest Department of Health initiative aimed at tackling the problem.

Researchers spent 300 hours observing departments at Southampton University Hospitals Foundation Trust, Guy’s and St Thomas’ Foundation Trust and Chesterfield Royal Hospital Foundation Trust.

They concluded lack of information for patients and their companions was the main factor responsible for driving up frustration levels, which frequently spilled over into abuse, aggression or violence.

As a result, the council has developed a simple flow diagram that can be used on posters and in leaflets to explain to patients how they will move through the system. It has also recommended television screens be hooked up to hospital information systems to let patients know how long their wait is likely to be.

Southampton A&E advanced nurse practitioner Karen Grant said: “It’s not always the high profile assaults and damage [that are the problem], it’s the day to day grumbling that wears you down and contributes to staff exhaustion.

“For the staff dealing with it every day, just knowing there was a project looking at it has had a tremendous effect on morale.”

However, she told Nursing Times it was important to be realistic because there were always going to be some periods of tension in the department.

Southampton A&E matron Erica Wallbridge added that the researchers had made staff walk through the A&E department to see if they could find their way around without speaking to anyone, in the same way that a patient might. “We had to admit if we didn’t know the department we would struggle,” she said.

Click here to see the research and online toolkit visit

  • Last week the DH and the Design Council also launched a set of new bedside furniture as part of a project called Design Our Bugs to reduce hospital acquired infections.

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