Violence against emergency department (ED) nurses is on the rise, according to a study recently released by the Emergency Nurses Association (ENA), Des Plaines, Ill.

Nearly 13 percent of ED nurses reported experiencing physical violence over a seven-day period in 2010, compared with 11 percent over a similar period in the prior year, the survey reports. About 53 percent of nurses experienced verbal abuse over a seven-day period in 2010 compared with 54 percent in the prior year. More than 7,000 ED nurses were surveyed for the report.

ENA research shows that nearly 56 percent of patients who physically assaulted nurses were under the influence of alcohol, 47 percent were under the influence of illicit or prescription drugs and 45 percent were mentally ill. Nearly all perpetrators were patients, according to the report.

"EDs are not always made safe enough for these types of patients or the staff who are asked to care for them," says Gail Lenehan, R.N., FAEN, FAAN, president of ENA.

ENA research shows there are lower rates of abuse when panic buttons, locked entries, enclosed nurses' stations, call code pseudonyms, security signs and well-lit areas are used in the ED.

"But the most effective approach is a violence mitigation program that includes facilities management that listens to staff to understand what they need to keep themselves and their patients safe," notes Lenehan.

ENA has developed a toolkit to help ED managers assess their departments and problems. Visit