Whether using this toolkit to implement an actual plan or to first review the steps necessary to creating change in your emergency department, the ENA Workplace Violence Toolkit explains the steps needed and provides you with tools for project planning and implementation. The end result of using this toolkit is a targeted quality improvement initiative that aims at improving the safety of your staff, patients and visitors in the emergency department. While we would all like to see the occurrence rate of violent behaviors in the emergency department at zero, the reality is that the nature of the patient population and the dynamics of critical, emergent care lend itself to the reality that violent behaviors are going to occur. This toolkit emphasizes prevention, but also addresses the important role of prepared response and occurrence reporting in a comprehensive safety program.

Change can happen one emergency department at a time and initiation of a project that protects the safety of patients and staff, enforces a change in attitudes and beliefs surrounding what is acceptable behavior and resets the standard, contributes to the advancement of the nursing profession and the specialty of emergency nursing.


ENA Emergency Department Violence Work Team 2009-2010

Karen Wiley, MSN, RN, CEN, chairperson
Diane Hochstetler, BSN, RN, CEN
Tracy Jenkins, BS, RN
Jessica Taylor, BSN, RN, CEN

Board Liaison

Mitch Jewett, RN, CEN, CPEN

Staff Liaisons

Suling Li, PhD, RN, director, IENR
Altair Juarez, MPH, senior research associate
Leslie Gates, senior administrative assistant, IENR

Special Recognition

Special recognition is extended to Diane L. Muench, MBA, RN, OCN, ENA consulting editor, for her extensive contributions to the development of the toolkit.

Additionally, ENA would like to recognize the many staff who comprise multiples departments within ENA who contributed to the development of this toolkit, which include the departments of Communication; Education Course and Product Development; Education Program and Product Delivery; the Institute for Quality, Safety, and Injury Prevention; Marketing; and Online Services.


This toolkit is designed to provide emergency nurses with the resources needed to make a violence prevention initiative an ongoing reality in every emergency department. It was created by ENA through the collaborative effort of your emergency nursing peers. Share your knowledge and experiences with us! We welcome your feedback and encourage you to forward your comments and suggestions to: IENR@ena.org or call us at (800) 900-9659 extension 4119.


The Emergency Nurses Association’s Emergency Department Workplace Violence Toolkit was developed by ENA members to provide emergency nurses with information and strategies they can use in connection with the development of a comprehensive plan addressing workplace violence in the emergency department. The information and recommendations contained in the toolkit reflect current knowledge at the time of publication, are only current as of their publication date, and are subject to change without notice as advances emerge. Additionally, variations in practice, which take into account the needs of individual emergency departments, institutions, patients and the resources and limitations unique to the health care setting, may warrant approaches that differ from the recommendations outlined in this toolkit. Therefore, these recommendations should not be interpreted as an exclusive course of workplace violence management, nor does the use of such recommendations guarantee a particular outcome. This toolkit has been published by ENA for educational and informational purposes only, and ENA does not “approve” or “endorse” any specific methods, practices or sources of information. ENA assumes no liability for any injury and/or damage to persons or property arising out of or related to the use of this toolkit or the implementation of any of the strategies or plans discussed in the toolkit in a health care setting.


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