Violence in the accident and emergency department--an international perspective.

Violence and aggression experienced by emergency nurses has been the focus of international concern. This paper examines the phenomena of violence experienced by emergency department nursing staff from an international perspective by reviewing original, published research studies. Methodological inconsistencies and concerns, a lack of comprehensive studies and persistent under-reporting may mean that the reality of clinical practise has not being captured by researchers. The literature suggests that clients presenting with weapons in the emergency department may be characteristic of North American departments but is much less likely to occur in the United Kingdom were weapons use is much more likely to be opportunistic. Excessive verbal abuse is a global phenomenon and nursing staff and organisations may be significantly affected by workplace violence. However, violence against nursing staff remains poorly researched or understood.