Professionals in the healthcare industry suffer a disproportionately high number of violent events and physical injuries in the workplace. According to the Occupational Safety and Health Administration (OSHA), 2016 saw U.S hospitals record 228,200 work-related injuries and illnesses, a rate of 5.9 work-related injuries and illnesses for every 100 full-time employees. That’s around twice the rate of private industry as a whole. The Covid-19 pandemic seems to have made the situation worse, with some parts of the country seeing violence against health workers increase by a shocking 300%.
In order to prevent violence and improve workplace safety, employers and managers need to take concrete steps to keep their doctors, nurses, and healthcare workers safe. While violent incidents are unlikely to disappear overnight, creating a more secure work environment will help professionals to feel safer and enable them to care for patients to the best of their abilities.
Workplace Violence in Healthcare
Violence in the workplace has long been a problem in healthcare facilities across the country. In fact, in many areas, the issue is so bad it’s now become viewed simply as “part of the job”.
According to a recent study, 70–74% of workplace assaults in the USA occur in healthcare settings. Among staff in nursing homes and residential care facilities, the rate of violent incidents is around 10 times the national average. While those working in psychiatric and substance abuse hospitals experience violence at roughly 60 times the rate of the average US workplace.
Types of Workplace Violence in Healthcare
According to the CDC, there are four main types of workplace violence in healthcare. These are criminal intent, client-on-worker violence, worker-on-worker violence, and violence from personal relationships.
Criminal intent
Criminal intent refers to violence that’s committed by someone with no known links to, or relationship with, the healthcare setting or its employees. It could include a nurse being attacked in the parking lot on her way home or a doctor being mugged when conducting a home visit. In general, this type of violence is fairly rare.
Client-on-worker
This is the most common type of violence experienced by healthcare workers. The client in this context includes the patient, their family members, and their friends. Those most likely to experience this type of violence are emergency department workers and those working in mental health facilities, waiting rooms, and geriatric care.
Worker-on-worker
Violence between co-workers is also known as lateral or horizontal violence. It can include everything from bullying and intimidation to emotional abuse and homicide.
Personal relationship
The violence that comes about as a result of personal relationships can happen in all healthcare settings. An example of this type of violence would be a husband following his nurse wife to work and attacking her on the hospital premises.
Causes of Workplace Violence in Healthcare
The causes of workplace violence in healthcare vary from place to place and incident to incident. As we’ve seen, violent events can fall into four broad categories, with each presenting its own risk factors and triggers.
However, while the exact causes of violence can’t always be identified, policies and programs that target violent behavior can be effective in addressing workplace incidents of violence. For example, the integration of rapid response programs and technologies has the potential to reduce the severity of incidents as they happen, while de-escalation training can be incredibly useful in defusing situations that may arise once a qualified member of staff has arrived.
Lack of Reporting
While the causes of workplace violence in healthcare settings are nebulous and often facility specific, a lack of reporting compounds the problem—regardless of the challenges faced by individual facilities. Put simply, when violence against healthcare workers goes unreported, the ability to address and prevent future incidents effectively is negatively affected. Under reporting or neglecting to report incidents in a timely manner may have the following consequences:
Inadequate Data
Lack of reporting leads to incomplete or inaccurate data regarding workplace violence incidents in healthcare facilities. This makes it difficult for organizations to fully understand the scope and severity of the problem, affecting the ability to allocate resources and implement appropriate preventive measures.
Underestimation of the Issue
When incidents of workplace violence are not reported, there is a risk of underestimating the magnitude of the problem. Without a clear understanding of the frequency and severity of violent incidents, organizations may fail to prioritize and allocate sufficient resources for workplace violence prevention initiatives.
Missed Opportunities for Intervention
Reporting incidents of workplace violence is crucial for prompt intervention, enabling organizations to identify patterns, assess risk factors, and implement preventive measures to address the root causes. Without proper reporting, opportunities to intervene and prevent future incidents may be missed.
Prolonged Exposure to Risk
Failure to report workplace violence incidents prolongs the exposure of healthcare workers to potentially dangerous situations and individuals. This increases the risk of further violence, placing employees at continued risk and potentially compromising their safety and well-being.
Impacted Workplace Culture
Lack of reporting can contribute to a culture of silence and acceptance of violence in the workplace. Employees may feel discouraged or fearful of reporting incidents due to concerns about retaliation or a perception that their concerns will not be taken seriously. This negatively impacts the overall workplace culture and hinders efforts to create a safe and respectful environment.
Various Risk Factors of Workplace Violence in Healthcare
These risk factors primarily relate to client-on-worker violence, the most common type of violence experienced by those working in healthcare organizations, and it is crucial to identify, educate, and monitor these risk factors to increase safety within the healthcare industry. This can be achieved by implementing the following:
Workplace Analysis and Hazard Identification
Conducting a thorough analysis of the healthcare facility’s work environment is crucial in identifying potential hazards and risks that could lead to incidents. This analysis involves evaluating the physical layout of the facility, identifying high-risk areas, assessing staffing levels, and considering factors such as access control, lighting, and visibility.
Safety and Health Training
Providing comprehensive training programs for all employees is vital to promote a safe work environment and prevent workplace violence. Training should cover topics such as recognizing warning signs, effective communication and de-escalation techniques, personal safety strategies, and protocols for reporting incidents. Ongoing workplace violence prevention programs and refresher courses should be conducted to ensure that employees are well-prepared to handle challenging situations.
Record Keeping and Program Evaluation
Keeping detailed records of incidents, near misses, and employee reports is essential for tracking patterns and trends related to workplace violence. This data can be used to evaluate the effectiveness of prevention measures and identify areas that require improvement. Regular program evaluations should be conducted to assess the overall effectiveness of workplace violence prevention strategies and make necessary adjustments to enhance the safety of the healthcare environment.
Tips and Strategies for Preventing Workplace Violence in Healthcare
These simple measures can have a big impact on the level of violence experienced by staff members. Implementing an emergency communication system, and ensuring healthcare professionals undergo relevant training programs, can also have an instant and significant impact on physical assaults and threatening behavior. In addition, these strategies can help prevent and mitigate workplace violence in healthcare settings.
Participate in Your Facility
Take an active role in workplace safety by participating in safety committees, attending training sessions, and providing input on policies and procedures. Collaborate with colleagues and management to develop and implement violence prevention programs.
Dress for Safety
Wear appropriate attire that allows for ease of movement and quick identification as a healthcare professional. Avoid clothing or accessories that may provoke or escalate aggressive behavior.
Be Aware of Your Work Environment
Stay alert and be aware of your surroundings at all times, familiarize yourself with escape routes, emergency exits, and panic buttons, and report any safety hazards or concerns promptly to management.
Be Aware of Patient Behaviors
Pay attention to changes in individual behaviors and be mindful of warning signs that may indicate escalating aggression or potential violence. This can include verbal threats, physical aggression, agitation, or signs of substance abuse or withdrawal.
Use Violence Risk Assessment Tools
Implement violence risk assessment tools or checklists to identify individuals who may be at a higher risk of displaying violent behavior. These tools can help healthcare professionals evaluate the likelihood of violence and develop appropriate preventive measures.
Check Your Socio-Cultural Biases
Be mindful of your own biases and stereotypes that may influence your perception or response to certain individuals or situations. Treat individuals with respect and fairness, regardless of their background or personal characteristics.
Further resources on workplace violence prevention can be found on The Joint Commission website and in the OSHA guidelines, as well as by following this NIOSH link from the CDC.
Do you Need a Workplace Violence Program?
Violence against healthcare workers is always completely unacceptable. Implementing workplace violence prevention programs can help to reduce violence in a number of ways. Programs can provide essential training for healthcare workers and can be used to inform employees and employers about the steps they can take to reduce assaults and minimize risk.
Whether or not your healthcare facility has experienced violence, investing in a program is an important way of boosting security. It also demonstrates to employees that their safety is a top priority, something that can further help to improve the working environment.
Workplace violence in healthcare settings is a growing concern and an important public health issue. To learn more about violence prevention, and how panic buttons can help to keep your employees safe, get in touch with a member of our team today. Request a demo.