Outcomes of white code notifications given after violence for healthcare providers in the emergency department of Dokuz Eylül University Hospital

Introduction and Objective: In this study, it was aimed to evaluate the consequences of the White Code notifications given from the Emergency Departments of Dokuz Eylul University Hospital (DEUH) and subsequent legal processes, as well as the effects of the reporting on the psychological status of the healthcare providers. Materials & Methods: For the study, 98 White Code notifications in DEUH Emergency Departments during January 1, 2018 and December 31, 2019 were examined and the reason of the incident, the characteristics of the victim-perpetrator and their legal consequences were scrutinized. Six employees of whom either were not accessible or did not give their informed consent, were excluded from the study, and a total of 61 healthcare professionals constituted the case group of our study. Sixty employees of DEUH Emergency Departments who have not reported a White Code statement during their working life were included in the study as a control group. Health care providers in the case and control groups were provided to fill the Maslach Burnout Inventory (MBI), Perceived Stress Scale (PSS), Beck Hopelessness Scales (BHS) by face-to-face interview. Through the individuals' registered their burnout, hopelessness and stress perception levels were compared. Results: In the study there were 98 White Codes, 61 health care providers who reported White Code and 60 health care providers who have not reported White Code were included. 49% of the notifications were from the emergency departments and 61.2% were men; 85.8% of those working in the 20-29 age range; 83.6% were reported by physicians and 79.6% were reported out of working hours. 70% of the participants in the study reported that they did not report White Code for the current violence, despite being exposed to violence. All notifications were left out of the White Code coverage and lacked legal aid. The announcement of the verdict was deferred in 84.0% of the 25 White Code cases that resulted in legal punishment. Having previously reported White Code was related to the profession (p<0.001), age (p=0.031), time spent in the profession (p=0.048), but there was not significant relationship to the gender of the employees (p=0.409) and the level of knowledge about the practice of the White Code (p=0.33) and whether they found the procedures functional (p=0,1). There was no difference between the total scores of those who previously reported White Code and those who did not report MBI (p=0,257), PSS (p=0,485) and BHS (p=0,321). Conclusion: Healthcare providers do not report White Codes due to the contemplations that White Code procedures take long and are not useful, and do not receive sufficient legal support after notifications. Supporting healthcare providers within the scope of this practice and facilitating the reporting will enable more incidents to be reported. White Code Reporting of health care providers does not cause changes in their levels of burnout, hopelessness and stress perception. Keywords: Health, workplace, violence, White Code, hopelessness, burnout, stress