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

Moore, Simon ORCID: https://orcid.org/0000-0001-5495-4705, Van Godwin, Jordan ORCID: https://orcid.org/0000-0001-5288-6614, Moore, Graham ORCID: https://orcid.org/0000-0002-6136-3978, Hamilton, Megan and O'Reilly, David 2025. Practitioner experiences of developing and implementing two UK ED-based hospital violence intervention programmes: a process evaluation. Emergency Medicine Journal 10.1136/emermed-2024-214333

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Abstract

Background EDs 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. Methods This 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. Results HVIPs 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. Conclusion The 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.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Social Sciences (Includes Criminology and Education) Schools > Dentistry Research Institutes & Centres > Centre For Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Publisher:	BMJ Publishing Group
ISSN:	1472-0205
Date of First Compliant Deposit:	5 March 2025
Date of Acceptance:	21 January 2025
Last Modified:	05 Mar 2025 15:00
URI:	https://orca.cardiff.ac.uk/id/eprint/176617

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