Stop Workplace Violence Against Health Care Workers

November 10, 2022

As a health care worker, you may often find yourself in high-stress environments—waiting rooms, emergency departments, behavioral health units, etc. While health care settings are essential places of healing, they are also commonly home to crisis situations and verbal abuse.

Here are some of the statistics on violence against health care workers:

  • According to OSHA, 75% of nearly 25,000 workplace assaults reported annually occurred in healthcare and social service settings. (OSHA – 2022)
  • In health care settings, patients account for 80% of violence against health care workers. (OSHA)
  • In November 2020, 20% of nurses reported an increase in attacks against them. (Legal Jobs – 2022)
  • While workplace violence can occur in any organization in any industry, it's about four times more prevalent in healthcare than it is in other industries. (Cleveland Clinic – 2021)
  • 73% of the nonfatal occupational injuries tracked by The U.S. Bureau of Labor Statistics in 2018 occurred in healthcare and social assistance.
  • And according to an article in Occupational Health & Safety:
    • Over a 12-month period, 21% of registered nurses and nursing students reported being physically assaulted, and 50% verbally abused.
    • Over a seven-day period, 12% of emergency department nurses experienced physical violence, and 59% experienced verbal abuse.
    • In one year, 13% of employees in Veterans Health Administration hospitals reported being assaulted.

Workplace violence is something often considered a “normal occurrence,” but it can be mitigated with the proper de-escalation techniques.

Our Workplace Violence Continuum of Behaviors shows the escalation of workplace violence, from discourtesy up to and including physical aggression.

Workplace violence continuum

The Importance of De-escalation Training

Many regulations and state laws require training for all health care workers. This requirement covers everyone who encounters individuals in a health care setting—from nurses, doctors, and social workers to security, pharmacy, and customer service staff.

Start the process of helping your team members become safer by viewing our Risk Stratification Matrix. The matrix demonstrates the degrees of risk that different departments face and helps determine the best mix of training to make your hospital measurably safer.

The Joint Commission recommends training all staff using de-escalation techniques as soon as threatening language and agitation are identified. Guiding staff using CPI’s “Top 10 De-Escalation Tips” is a great resource for breaking down the fundamental strategies from CPI training.

Implement an Effective Workplace Violence Prevention Plan

It is likely that most, if not all, facilities already have some sort of program in place to prevent violence against health care workers. However, very few entities truly have all the pieces in place, functioning at the highest level of efficacy. CPI approached health care professionals and subject matter experts Kimberly Urbanek and Kyle Graham to develop the Workplace Violence Prevention Handbook. The goal: to serve as a comprehensive resource to establish and build out the necessary components of a successful workplace violence prevention program.

You may know that there are already existing regulations and guidelines on what a workplace violence prevention program should entail, but the first-hand knowledge and comprehensive/how-to approach applied to this ever-evolving handbook truly set health care organizations up to successful implementation. We encourage you to learn more about the handbook and the characteristics that set it apart.

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Seven Additional Actions to Address Violence Against Health Care Workers

Here are seven actions your facility can take to be ready when violence against health care workers—or the potential for violence—occurs:

1. Clearly define workplace violence and put systems into place across the organization that enable staff to report workplace violence instances, including verbal abuse.

CPI can help you develop a definition of workplace violence that includes the full range of behaviors staff might encounter. Additionally, our Nonviolent Crisis Intervention® program gives you tools to train staff in documenting and reporting verbal (and physical) incidents as part of the debriefing process. We also offer industry-leading supports like troubleshooting guidance, plus reporting tools and supplemental training on incident reporting.

It’s also important to remember that putting an effective workplace violence prevention program into place starts at the top, with leadership.

2. Recognizing that data come from several sources, capture, track and trend all reports of workplace violence – including verbal abuse and attempted assaults when no harm occurred.

CPI’s debriefing model and documentation tools can help you capture, track, and trend all incidents of workplace violence, including verbal abuse and physical aggression. Nonviolent Crisis Intervention® training also helps you use Postvention for prevention; use incident reviews to guide you in making changes to prevent similar situations from happening.

3. Provide appropriate follow-up and support to victims, witnesses, and others affected by workplace violence, including psychological counseling and trauma-informed care if necessary.

The CPI COPING ModelSM guides you through the process of giving caring, constructive support to everyone involved in an incident—victims, witnesses, staff, patients, family members, or visitors.

The core belief and teaching of Nonviolent Crisis Intervention® training is that everyone deserves to be treated with care and safety.

Everyone should be empowered to provide safe, caring treatment for themselves and others. As part of this, we’ll help you incorporate trauma-informed care best practices into your staff trainings, policies, and procedures.

4. Review each case of workplace violence to determine contributing factors.

Analyze data related to workplace violence, and worksite conditions, to determine priority situations for intervention.

When you use CPI’s prevention, response, and debriefing protocols, you’ll find determining contributing factors to be one of your most crucial and effective tools.

5. Develop quality improvement initiatives to reduce incidents of workplace violence.

Facilities that work with CPI choose us because they want to create lasting, positive, ongoing change that pays off in terms of time, cost, and people.

6. Train all staff, including security, in de-escalation, self-defense and response to emergency codes.

A well-trained staff, equipped with the skills and confidence to safely recognize and de-escalate challenging behaviors, are critical to the well-being of both patients and staff. It creates a safer environment that in turn leads to a more satisfied workforce, replacing turnover and burnout with increased employee performance.

With CPI training for all staff, you can break the cycle of workplace violence. You’ll learn verbal de-escalation skills, how to block and move away from strikes and grabs, how to respond to and reduce emergency codes, and many more skills that can be life-saving at the most, and job-enhancing to say the least.

7. Evaluate workplace violence reduction initiatives.

CPI is always here to help you evaluate your initiatives and keep making improvements every day. If you choose to schedule a free risk assessment with a CPI representative, we will review the current policies you have in place, discuss the areas in which challenges are arising, and identify the appropriate steps to ensure you remain in compliance with you facility’s governing bodies, as well as the Centers for Medicare & Medicaid Services.

Receive a Digital Copy of the Workplace Violence Prevention Handbook

Want to learn more on how leaders can begin and recommend approaches for implementation? The strategies discussed here are from the Workplace Violence Prevention Handbook, published by CPI and authored by health care professionals for health care professionals.

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