The survey was sent to 4,600 emergency department nurse managers, and approximately 1,400 responded. Most respondents were nurse managers (67 percent), followed by nursing directors (21 percent) and nursing administrators (5 percent). About 7 percent of respondents were staff nurses, clinical nurse specialists, or nursing supervisors. Survey participants confirmed that emergency department violence was on the rise. The most common contributing factors to emergency department violence were alcohol, drugs, anger, and high stress. The most frequent safety measures instituted in hospitals included policies and procedures, panic buttons, metal detectors, and bullet proof glass. About 97 percent of respondents said that staff were exposed to verbal abuse more than 20 times per year. According to 87 percent of respondents, staff were exposed to physical assault without weapons 1 to 5 times per year; 24 percent of respondents were exposed to physical violence with weapons 1 to 5 times per year. Exposure to violence in the emergency department caused injuries and time lost from work. Most nursing managers reported violent incidents to nursing directors, hospital administrators, risk managers, and security personnel. The ENA recommends that legislation, hospital policies and procedures, prevention education, and reporting mechanisms be instituted in hospital emergency departments to curb violence. Additional information on violence in the emergency room setting and the ENA survey form are appended. 20 references