Educational Tools/Resources

• Introduction - Violence in the Workplace | NIOSH | CDC: Workplace violence is an unfortunately prevalent problem with approximately 1 million people assaulted while at work or on duty each year as estimated by the National Crime Victimization Survey.

• TABLE R4. Number of nonfatal occupational injuries and illnesses involving days away from work by industry and selected events or exposures leading to injury or illness, private industry, 2020 (bls.gov). Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics. Healthcare workers are at high risk of workplace violence with 7,880 nonfatal workplace violence injuries among hospital-based healthcare workers and 5,720 in nursing and residential care facilities in 2020.  It is a widely held assumption that healthcare workers greatly underreport workplace violence because of a lack of awareness, fear of retaliation, unintentional assaults, and persistent perception that workplace violence is part of the healthcare profession.

• Workplace Violence Prevention for Nurses | NIOSH | CDC: There are a few steps that healthcare providers and their employers must take to address workplace violence.  First is a recognition that there is a problem.  Secondly is to provide education to healthcare providers to better understand the extent of violence in the workplace, how to recognize signs of potential violence, develop communication skills to address workplace violence, and have appropriate resources easily accessible if there is an incident of workplace violence.  The National Institute for Occupational Safety and Health (NIOSH) has developed a Workplace Violence Prevention for Nurses Course for this purpose. 

• Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers (osha.gov) OSHA issued its Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers in 2004 which highlights the five major elements of an effective workplace violence prevention program: management commitment and employee involvement, worksite analysis, hazard prevention, and control, safety and health training, recordkeeping and program evaluation.

• Developing & Implementing a Workplace Violence Prevention Program & Policy | NIOSH | CDC: Each workplace must have a policy in place to identify and subsequently address workplace violence.  NIOSH has a guide for the development and implementation of such a program and policy. 

• 2019-2020 Annual Report - Workplace Violent Incidents at Hospitals (ca.gov) Workplace Violent Incident Online Reporting in Healthcare. Following the passage of Senate Bill 1299 in 2014, California Occupational Safety and Health Administration (OSHA) developed a regulation for hospitals to adopt workplace violence prevention plans.  This requires hospitals to submit reports to Cal/OSHA regarding any workplace violence including the use of an online reporting system.

Reports/Publications

• Kumari A, Sarkar S, Ranjan P, Chopra S, Kaur T, Baitha U, Chakrawarty A, Klanidhi KB. Interventions for workplace violence against health-care professionals: A systematic review. Work. 2022 Apr 13. DOI: 10.3233/WOR-210046. Epub ahead of print. PMID: 35431213. There is a growing literature on workplace violence and strategies for intervention.  A systematic review done by Kumari et al suggests that workshop-based formats are often used for education and teaching de-escalation techniques as well as utilizing simulated patient scenarios.
• Patterson S, Flaws D, Latu J, Doo I, Tronstad O. Patient aggression in intensive care: A qualitative study of staff experiences. Aust Crit Care. 2022 Apr 12:S1036-7314(22)00032-7. DOI: 10.1016/j.aucc.2022.02.006. Epub ahead of print. PMID: 35428553.
• Intervention and de-escalation techniques are crucial but the emotional support, coping skills, and resilience training will also promote the well-being of healthcare providers.
• Kaplan, Lewis J. MD, FACS, FCCM Society of Critical Care Medicine Presidential Address−49th Annual Congress, February 2020, Orlando, Florida, Critical Care Medicine:  May 2020 - Volume 48 - Issue 5 - p 615-617. DOI: 10.1097/CCM.0000000000004312.  The 49^th Society of Critical Care Medicine Annual Congress included sessions on addressing workplace violence and conflict mediation in the ICU.

Links to Other Resources

• Workplace Violence - The American Association for the Surgery of Trauma (aast.org)
• New workplace violence prevention standards take effect January 2022 | The Bulletin (facs.org). The American Association for the Surgery of Trauma and the American College of Surgery provide education and resources to increase awareness of workplace violence and improve patient and worker safety.
• Workplace Violence Prevention | The Joint Commission: Checklist for TJC Workplace Violence Standards (mediapartners.com)The Joint Commission offers workplace violence prevention resources as well as new and revised Workplace Violence Standard for hospitals and critical access hospitals accredited by the Joint Commission that took effect January 2, 2022.  Individual healthcare providers, hospital administrations, and national leadership organizations working together can help reduce the incidence of workplace violence and minimize the harmful effects on emotional and physical wellbeing.