Attitudes Toward the Use of a Metal Detector in an Urban Emergency Department,☆☆,

Presented at the Rocky Mountain Conference of Emergency Medicine, Breckenridge, CO, March 1996.
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Abstract

Study objective: To determine the attitudes of patients, their family and friends, and ED staff toward a walk-through metal detector in the ED. Methods: We conducted a survey of a convenience sample of ED patrons (patients and their friends and family) and staff at a university-affiliated Level I trauma center. Results: We surveyed 176 patrons and 95 employees (35 nurses, 30 physicians, 16 security officers, and 14 staff members). Overall, 80% of the patrons and 85% of the employees said they liked the metal detector. Eighty-nine percent of the patrons and 73% of the employees said the metal detector made them feel safer. Only 12% of the patrons and 10% of the employees said the metal detector invaded their privacy or the privacy of others. Fewer than 1% of the patrons said they were less likely to return to our ED because of the metal detector, and 39% said it made them more likely to return. We detected no significant differences with regard to age, sex, or race. Conclusion: Most patrons and staff liked the metal detector and said it created a safer ED environment. Only a few disliked the presence of the metal detector or said it invaded their privacy. Institutions concerned about their employees' and patrons' perceptions of safety should consider installing metal detectors in their EDs. [Meyer T, Wrenn K, Wright SW, Glaser J, Slovis CM: Attitudes toward the use of a metal detector in an urban emergency department. Ann Emerg Med May 1997; 29:621-624.]

Section snippets

INTRODUCTION

Urban EDs treat a substantial number of assault-, firearm-, and gang-related injuries. As a result, the risk of violent behavior on the part of patients and their friends, family members, and enemies, who might bring concealed weapons into the ED, is increased. In fact, surveys have demonstrated that violent or potentially violent events are relatively common in the ED. For instance, 20% of EDs report at least one threat with a weapon each month.1 The threat of violence is therefore a

MATERIALS AND METHODS

We conducted our study in the ED of Vanderbilt University Hospital, an urban university hospital located in Nashville, TN. The hospital is the only Level I trauma center serving a metropolitan area of approximately 1 million people. Patients not brought by ambulance, along with their family and friends, must pass through a metal detector to enter the triage area and waiting room. The metal detector is staffed 24 hours a day by a university security guard. The initial equipment and setup charges

RESULTS

We interviewed 176 patrons (62 patients, 114 family members or friends) and 95 ED employees (35 nurses, 30 physicians, 16 security officers, and 14 staff members). Among the patrons, 50% were women and 40% were black. Their mean age was 40.3 years (range, 18 to 82 years), and 45 (26%) were interviewed between the hours of midnight and 8 am.

Eighty percent of patrons and 85% of employees said they liked the metal detector. Ninety percent of patrons and 73% of employees said they felt safer with

DISCUSSION

Although reported threats with weapons in our ED were few before the installation of the metal detector, this phenomenon has been a problem in other hospitals. In a survey of 127 US teaching hospital EDs, 20% reported at least one threat with a weapon each month, and 46% reported the confiscation of a weapon at least once a month.1 In another study of the prevalence of weapons possession by ED patients, 500 patients suspected of carrying weapons were searched over a 20-month period; 89 (18%)

Acknowledgements

We acknowledge the efforts of Paul Biddinger, Randall Grubbs, and Daniel Penn in data collection.

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From the Vanderbilt University Medical Center, Nashville, Tennessee.

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Reprint no.47/1/80645

Address for reprints: Seth Wright, MD Department of Emergency Medicine Vanderbilt University Medical Center 703 Oxford House Nashville, TN 37232-4700

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