Practitioner experiences of developing and implementing two UK ED-based hospital violence intervention programmes: a process evaluation

• Published in: Emergency medicine journal : EMJ Vol. 42; no. 8; pp. 536 - 541
• Main Authors: Moore, Simon, Van Godwin, Jordan, Moore, Graham, Hamilton, Megan, O’Reilly, David
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine 01.08.2025; BMJ Publishing Group LTD
• Subjects: Attitude of Health Personnel; Consent; Content analysis; Data collection; Domestic violence; emergency care systems; Emergency medical care; Emergency Service, Hospital - organization & administration; Health promotion; Hospitals; Humans; Intervention; Interviews; Male; non-accidental; Nurses; Original research; Patient-centered care; Patients; Prevention; Program Development - methods; Program Evaluation - methods; Qualitative Research; Sex crimes; United Kingdom; violence; Violence - prevention & control; United Kingdom; United Kingdom > UK; non-accidental; emergency care systems; violence
• ISSN: 1472-0205; 1472-0213
• DOI: 10.1136/emermed-2024-214333

BackgroundEDs can address modifiable risks of patients attending due to violence. Hospital-based violence intervention programmes (HVIPs) can reduce patients’ exposure to violence but can place additional burdens on staff. We explored practitioners’ views on two nurse-led HVIPs’ design and delivery, response to patient need, engagement with ED health professionals, adaptation to local context and analysed documents relevant to these objectives.MethodsThis was a qualitative process evaluation, from January to September 2023, of two nurse-led HVIPs implemented in a major trauma centre and a large urban hospital in the UK. Interview participants (N=49) were involved with the commission and implementation of the HVIPs, or worked within the broader violence-prevention ecology. We gathered perspectives on intervention implementation and undertook documentary analysis on local and national policies, and guidance relating to HVIPs development, implementation and delivery (N=46). Documentary data were subject to thematic and content analyses, interview data to thematic analysis.ResultsHVIPs were developed in response to a perceived under-provision of services for patients attending EDs due to violence. The HVIP nurses had access to clinical records facilitating the identification of eligible patients. They provided patient-centred care, addressing needs through referrals into health and community-based services. Over 60% of eligible patients engaged. The nurses were seen as credible champions working towards a minimally burdensome service that supported and trained ED staff. Embedding HVIPs into usual care took time and was limited by the perceived short-term nature of the intervention.ConclusionThe implementation of nurse-led HVIPs enables access to clinical records, facilitating patient engagement, and can provide an additional service aligned to usual emergency care, supporting both patients and ED staff.Pre-RegistrationThe protocol was pre-registered (ISRCTN 15286575; March 13, 2023) and published before data collection was complete.