30/03/2020

Workplace Violence

By
Dr. Ali Saleh
School of Nursing
The University of Jordan

Workplace Violence
 Workplace violence: violent acts (including physical
assaults and threats of assaults) directed toward
persons at work or on duty. (The National Institute
for Occupational Safety and Health (NIOSH))
 Outsider - Person with no relationship of any kind
with a victim of workplace-violence incident or
his/her employer.
 Employee-related outsider - Person with some type
of personal relationship (past/present) with an
employee, but no work-related relationship with the
employee.
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Workplace Violence
• High-risk occupations in terms of workplace
violence:
– Taxicab drivers; retail workers.
– Police and security officers.
– Finance, insurance, real estate.
– Health care; Community service employees.

Healthcare Workplace Violence

• Violence in hospitals usually results from patients and
occasionally from their family members who feel
frustrated, vulnerable, and out of control.
• Although anyone working in a hospital may become a
victim of violence, nurses and aides who have the most
direct contact with patients are at higher risk
• Violence may occur anywhere in the hospital, but it is
most frequent in the following areas:
– Psychiatric wards
– Emergency rooms
– Waiting rooms
– Geriatric units

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Tasks or Situations Associated with

Healthcare Violence

• Transporting patients
• Long waits for service
• The perception of poor care
• Overcrowded, uncomfortable waiting rooms
• Working alone in areas with high risks

Tasks or Situations Associated with

Healthcare Violence- cont.

• Inadequate security
• Patients on drugs or alcohol
• Weapons brought on facility
• Unrestricted access to facilities by the public
• Poorly lit corridors, rooms, parking lots, and
other areas

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Effects of Healthcare Workplace Violence

• Individuals Effects:
– Minor physical injuries
– Serious physical injuries
– Temporary and permanent physical disability
– Psychological trauma
– Death

Effects of Healthcare Workplace Violence

• Organizational Effects
– Low worker morale
– Increased job stress
– Increased worker turnover
– Reduced trust of management and coworkers
– A hostile working environment.

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Components of Violence Prevention Programs

1. Management Commitment/Employee
Involvement
o Management commitment, including the endorsement
and visible involvement of top management, provides
the motivation and resources for workers and employers
to deal effectively with workplace violence
o Through involvement and feedback, workers at various
organizational levels bring a broad range of experience
and skills and can provide useful information to
employers to design, implement and evaluate the
program.
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Components of Violence Prevention Programs

2. Workplace Analysis
A. Records Monitoring and Tracking: Records review
is important to identify patterns of assaults or near
misses that could be prevented or reduced
through the implementation of appropriate
controls
B. Trend Monitoring and Incident Analysis: Use
several years of data, if possible, to trace trends of
injuries and incidents of actual or potential
workplace violence.

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Components of Violence Prevention Programs

2. Workplace Analysis- cont.

C. Employee Surveys: is to give employees a
questionnaire or survey to get their ideas on the
potential for violent incidents and to identify or
confirm the need for improved security measures.
D. Workplace Security Analysis: The team or
coordinator should periodically inspect the
workplace and evaluate employee tasks to identify
hazards, conditions, operations, and situations
that could lead to violence.

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Components of Violence Prevention Programs

3. Hazard Prevention and Control

– Engineering controls: e.g. surveillance cameras,
adequate lighting.
– Administrative controls: e.g. proper work policies.
– Work Practice Controls: e.g. proper work practices.
4. Safety and Health Training: Education and training are key
elements
5. Record Keeping and Evaluation: Recordkeeping and
evaluation of the violence prevention program are
necessary to determine its overall effectiveness and identify
any deficiencies or changes that should be made

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Violence Prevention Strategies

Engineering Control
• Develop emergency signaling, alarms, and
monitoring systems.
• Install security devices such as metal detectors to
prevent armed persons from entering the
hospital.
• Install other security devices such as cameras and
good lighting in hallways.
• Design waiting areas to accommodate and assist
visitors and patients who may have a delay in
service.
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Violence Prevention Strategies

Engineering Control- cont.
• Design the triage area and other public areas to
minimize the risk of assault:
– Provide staff restrooms and emergency exits.
– Install enclosed nurses’ stations.
– Install deep service counters or bullet-resistant and
shatterproof glass enclosures in reception areas.
– Arrange furniture and other objects to minimize their
use as weapons.

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Violence Prevention Strategies

Administrative Control
• Design staffing patterns to prevent personnel
from working alone and to minimize patient
waiting time.
• Restrict the movement of the public in hospitals
by card-controlled access.
• Provide security personnel to the parking lots at
night.
• Develop a system for alerting security personnel
when violence is threatened.

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Violence Prevention Tips for Healthcare

Workers
• Watch for any signals of possible violence, such as
verbally expressed anger and frustration or body
language (e.g., threatening gestures).
• Look for signs of drug or alcohol use.
• Watch for the presence of a weapon.
• Maintain behavior that helps diffuse anger:
– Present a calm, caring attitude.
– Don’t give orders.
– Acknowledge the person’s feelings.
– Avoid any behavior that may be interpreted as aggressive.

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Violence Prevention Tips for Healthcare

Workers- cont.
• Evaluate each situation for potential violence when you
enter a room or begin to relate to a patient or visitor.
• Be vigilant throughout the encounter.
• Don’t isolate yourself with a potentially violent person.
• Always keep an open path for exiting
• Don’t let the potentially violent person stand between you
and the door
• Take these steps if you can’t defuse the situation quickly:
– Remove yourself from the situation.
– Call security for help.
– Report any violent incidents to your management.

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