Q: We know that violence is ubiquitous in healthcare settings. What's being done about it?
A: Workplace violence, which encompasses physical violence, harassment, intimidation, and any other threatening, disruptive behaviors ranging from verbal abuse to physical assault, remains a high priority for healthcare organizations, regulatory bodies, and professional organizations across the country. Compared with other industries, healthcare workers are four times more likely to be exposed to violence, according to the US Occupational Safety and Health Administration (OSHA).
Alarmingly, it's believed that only 20% to 60% of nurses report violent incidents, according to the American Nurses Association. Research has revealed that violence against healthcare workers is so common that most employees consider it to be part of the job. Nurses are at increased risk for experiencing violence due to a variety of reasons, including staffing demands and workplace stress, and ED nurses report the highest incidence. Perpetrators of violence can be patients, visitors, coworkers, bosses, healthcare providers, vendors, or even active shooters.
The response has been multifold, with education and lobbying for law enactment and improved legislation, along with an outpouring of advocacy from professional organizations. Currently, workplace violence reporting isn't mandatory on a national level, but it's required in some states (for example, California).
In April 2018, The Joint Commission released a sentinel event statement on workplace violence to help organizations “recognize and acknowledge workplace violence directed against healthcare workers from patients and visitors, better prepare staff to handle violence, and more effectively address the aftermath.” The Joint Commission now includes a survey of organizational plans, process improvements, policies, and reporting related to workplace violence. Due to this focus, reported incidents have increased.
In an effort to improve and increase reporting, OSHA launched a program called the Injury Tracking Application (www.osha.gov/injuryreporting), which is a secure website where applicable employers are required to submit their workplace injury and illness information, including acute injuries or illnesses, lost time from work, restricted work activity, or job transfer.
Where do we go from here? It's crucial that professional organizations advocate for improved safety measures, reporting processes, and staff education. These actions will drive reporting and the data will allow for tangible forward movement to produce and pass legislation.
US Occupational Safety and Health Administration. Workplace violence in healthcare: understanding the challenge. 2015. www.osha.gov/Publications/OSHA3826.pdf