[Position paper of the DGIIN-violence against healthcare personnel in emergeny departments and intensive care units].

BACKGROUND AND

OBJECTIVE

Violence against healthcare workers in emergency departments and intensive care units has increased significantly in recent years, posing a substantial threat to staff safety. In German emergency departments, 97% of staff report verbal violence and 76% report physical violence. The German Society for Medical Intensive Care and Emergency Medicine (DGIIN) presents the first comprehensive position paper on violence prevention and protective measures.

METHODS

The position paper was developed by an interprofessional author group of the DGIIN based on current research data, international literature, and clinical practice experience. It analyzes forms, frequency, causes, and consequences of violence in the hospital setting and develops concrete recommendations for action.

RESULTS

Violence manifests as verbal, physical, sexual, and racist assaults, with patient-related violence (type II) being most common. Main causes are intoxication (45%), long waiting times, staff shortages, and existential fears. Consequences include work disability to posttraumatic stress disorder (PTSD, 15.8%). The position paper defines eight action areas: standard operating procedures (SOPs), leadership responsibility, systematic incident reporting, mandatory training and de-escalation programs with emphasis on verbal and nonverbal communication techniques (active listening, body language), structured psychosocial support (acute care and peer support), staffing, security measures (services, structural modifications, alarm systems, video surveillance), legal protection.

CONCLUSION

Violence prevention and staff protection are essential to patient safety. Professional communication competencies are central de-escalation instruments. The DGIIN demands systematic implementation of all measures in hospitals and their integration into financing. A zero-tolerance culture toward violence, combined with preventive, intervening, and follow-up structures, secures workforce capacity and qualified personnel retention.