RUNNING HEAD: WORKPLACE VIOLENCE 1

Workplace Violence in Healthcare: Action Plan

Danielle McWilliams

Delaware Technical Community College

NUR 420 Nursing Policy

Dr. Lewis

October 6, 2019
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Introduction

Workplace violence is an increasingly concerning issue in healthcare. “According to

American Nurse Today, 67% of all nonfatal injuries caused by workplace violence occur in

healthcare” (West, 2019). What is workplace violence? “The National Institute for Occupational

Safety and Health defines workplace violence as violent acts, including physical assaults and

threats of assault, directed toward persons at work or on duty but also include verbal violence

including threats, verbal abuse, hostility, and harassment” (OSHA, 2019).

Problem of Workplace Violence

What is the problem of workplace violence in healthcare? “Healthcare workers are at an

increased risk for workplace violence; from 2002 to 2013, incidents of serious workplace

violence were four times more common in healthcare than in private industry on average”

(OSHA, 2019). Violence in healthcare is underreported, “a survey of 4,738 Minnesota nurses

found that only 69 percent of physical assaults and 71 percent of non-physical assaults were

reported to a manager, while one medical center found that half of verbal and physical assaults

by patients against nurses were never reported in writing” (OSHA, 2019). Many healthcare

workers “recognize that many injuries caused by patients are unintentional and are therefore

likely to accept them as routine or unavoidable” (OSHA, 2019).

Financial Impact of Workplace Violence

As healthcare workers, we must realize the importance of identifying and reporting

workplace violence as it significantly impacts costs. A study showed, “one hospital system had
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30 nurses who required treatment for violent injuries in a particular year, at a total cost of

$94,156 including $78,924 for treatment and $15,232 for lost wages” (OSHA, 2019).

“Workplace violence in any form comes at a high cost to the individual and institution

and has lasting effects on our healthcare system and deeply impacts clinicians on a personal and

professional level” (West, 2019). There can be a large range of impacts which include “effects

on self-esteem, relationships with co-workers, patient care, professional growth, recruitment,

and retention” (West, 2019).

Laws and Proposals

Currently, there is a bill in the Minnesota Legislature that is to lead to “better prevention

and preparation for healthcare workers caught with a violent patient; HF 1087 and SF 1071, are

bipartisan bills aimed at preventing violence against healthcare workers” (Keller, 2019). These

bills are geared to “develop preparedness and incident response action plans in collaboration

with healthcare workers, provide adequate security staff, allow healthcare workers to request

additional staff due to concerns over potential violence, and to provide training to all healthcare

workers on safety guidelines, incident response plan, how to properly de-escalate situations and

the worker’s rights regarding acts of violence” (Keller, 2019).

Representative Ro Khanna introduced the Health Care Workplace Violence Prevention

Act, H.R. 5223 in 2018, that “would mandate that the federal Occupational Safety and Health

Administration (OSHA) develop a national standard on workplace violence prevention that

would require health care facilities to develop and implement comprehensive facility and

unit-specific workplace violence prevention plans” (National Nurses United, 2018).

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Implementation for Change

To provide a thorough and effective workplace prevention program, facilities must

develop a workplace violence prevention program. “OSHA has determined that the best way

to reduce violence in the workplace is through a comprehensive workplace violence

prevention program that covers five core elements: management commitment and employee

participation, worksite analysis and hazard identification, hazard prevention and control,

safety and health training, and recordkeeping and program evaluation” (OSHA, 2015). It is

important after creation of a workplace prevention program, that it be evaluated for

effectiveness, appropriateness, and thoroughness. These programs are critical to teach

healthcare workers and staff to identify potential violent situations, use of the incident

response plan, how to properly de-escalate situations and request additional staff, and the

importance of a time-out and post-assessment.

Talking Points

1. The chilling truth of workplace violence in healthcare including prevalence of

workplace violence in healthcare; while also discussing recent workplace violence

acts in the U.S.

a. “In 2017, longtime ER nurse Elise Wilson was brutally stabbed in the neck

and arms by a patient in the Massachusetts hospital where she worked. A year

later, she is still in pain and unable to return to the nursing job she loved”

(West, 2019).
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b. “Last November, a shooter killed three people including a physician, a

pharmacy resident and a police officer at Mercy Hospital & Medical Center in

Chicago’s South Side” (West, 2019).

c. “In March last year, a gunman entered a veterans’ home in Northern

California and killed three staff” (West, 2019).

2. Overall impact of workplace violence.

a. Treatment costs

b. Lost wages

c. Increased risk of medication errors and patient infections

d. Cost of replacing nurses due to leaving profession because of injuries,

stress, fatigue and burnout

3. Benefits of an effective comprehensive workplace violence prevention program

a. Increased employee satisfaction

b. Increased patient safety

c. Improved quality of care

d. Promotion of constructive labor-management relationships

Goals
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I hope to create a standardized workplace violence prevention program for healthcare

facilities to provide staff with a secure place to work by increasing the certainty of safety

within the workplace. With creation of a standardized program, it will allow facilities to

tailor the program to their needs depending on patient diagnosis. For example, dif ferent areas

of nursing may be predisposed to violence in the workplace such as psychiatric nursing.

Secondly, I would like to decrease the stigma with workplace violence and provide education

to nurses across the nation. Nurses need to know that violence is not part of the job, whether

coming from patients, visitors, intruders and/or coworkers.

Plan into Action

In the next 90 days I would like to gather more scenarios of workplace violence that

has occurred in healthcare facilities, locally and throughout the United States. I would like to

learn about programs that different facilities have in place now and identify if these programs

are successful and if they have the five essential building blocks built into the program. By

comparing current programs of other facilities and as it relates to the prevalence of

workplace violence at the facility as well as staff and patient satisfaction and quality of care.

Lastly, I would like to gather more information from credible resources on how to create a

comprehensive workplace violence prevention program, and work on finding a way to

standardize the program for all facilities.

What do I want to accomplish?

Ultimately, I would like to provide education to all healthcare workers which will

identify the prevalence of workplace violence in today’s healthcare profession, emphasize to

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healthcare workers that violence is not part of the job as well as emphasizing importance of

reporting. Creating an awareness of workplace violence is important with the increased risks

healthcare workers face.

Conclusion

It is my belief that every healthcare worker deserves the right to a safe work

environment that is free of violence and to have the assurance of being treated with dignity

and respect. “As healthcare professionals, we must be advocates for not only our patients, but

also for ourselves; it is important to us all to stop the violence - if you see something, say

something” (West, 2019).

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References

Keller, M. (2019). Proposal protects healthcare workers from workplace violence. Retrieved

from https://mnnurses.org/proposal-protects-healthcare-workers-from-workplace-

violence/

National Nurses United. (2018). Nurses applaud introduction of H.R. 5223- Federal

legislation to prevent workplace violence in health care facilities. Retrieved from

https://www.nationalnursesunited.org/press/nurses-applaud-introduction-federal-

legislation-prevent-workplace-violence-health-care

The Occupational Safety and Health Administration (OSHA). (2015). Preventing workplace

violence: A road map for healthcare facilities. Retrieved from

https://www.osha.gov/Publications/OSHA3827.pdf

The Occupational Safety and Health Administration (OSHA). (2019). Workplace violence in

healthcare. Retrieved from https://www.osha.gov/Publications/OSHA3826.pdf

West, B. (2019). Workplace Violence: A serious problem in healthcare. Retrieved from

https://www.amnhealthcare.com/workplace-violence-a-serious-problem-in-healthcare/