Threshold of Safety: Preventing Violence in the Healthcare Workplace

The COVID-19 pandemic has threatened the physical and mental health and safety of healthcare workers around the world. Since early 2020, problems can be pinpointed to a lack of proper personal protective equipment in the early days of the pandemic to the increasing staffing shortages throughout the healthcare industry. Certainly, it’s no surprise that Stericycle’s 2022 Healthcare Workplace Safety Trend Report found that 71% of healthcare providers believe COVID-19 has had a negative impact on their sense of safety in the workplace. Exacerbating all of this are increasing numbers of reports and news stories of violence on our hospital campuses and in clinics worldwide.

Workplace violence in healthcare can sometimes be overlooked, yet dangers have drastically increased for all healthcare workers during the COVID-19 pandemic. A September 2021 survey from National Nurses United found that 31% of hospital nurses have reported a recent increase in violence in the workplace, up from 22% in March 2021. Another study found that 82% of nurses and other healthcare workers reported experiencing at least one type of workplace violence during the COVID-19 pandemic, and 64% have been verbally assaulted— a disturbing trend that has become commonplace.

If healthcare leaders are unable to address the uptick of violence against workers in their facilities, then the unfortunate, increasing exodus from the profession will continue to gain momentum.

An unsafe environment for healthcare workers can directly impact the quality of care being delivered to patients and, in turn, potentially negatively impact patient outcomes. A broad range of research shows that exposure to workplace violence can result in psychological distress and job dissatisfaction, increasing absenteeism, and higher employee turnover.

Moreover, increased workplace violence can harm a healthcare organization’s bottom line. A study from the American Hospital Association found that average violence prevention and response costs totaled nearly $2.7 billion, including $852 million in unreimbursed medical care for victims of violence and $429 million in medical care, staffing, indemnity, and other costs. Implementing a strong violence prevention plan helps further reduce risks that could greatly impact an organization’s revenue, freeing up funds for other programs that benefit patients and communities.

In observance of Workplace Violence Awareness Month, we’ve answered some common questions to help healthcare leaders take the lead in updating their operating guidelines to better align with workplace violence prevention guidelines set by the Occupational Safety and Health Administration (OSHA).

What Is Workplace Violence?

OSHA defines violence in the workplace as “any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site. It ranges from threats and verbal abuse to physical assaults and even homicide.” Sexual harassment is also considered workplace violence. Such acts of violence can be carried out by anyone encountered in the workplace. Notably, individuals can experience workplace violence outside of work.  

Who Is at Risk for Workplace Violence in a Healthcare Setting?

While the term “workplace” might suggest violence between coworkers, OSHA notes that workplace violence can affect and involve healthcare employees, patients, visitors, intruders, and outside vendors.

Moreover, OSHA indicates that from 2002 to 2013, healthcare workers were four times more likely to experience serious workplace abuse than private industry workers, often requiring days off for recuperation. Patients are the largest source of violence in healthcare settings, accounting for 80% of all healthcare workplace violence incidents.

What Are Common Risk Factors that Lead to Healthcare Workplace Violence?

The risk factors for violence in the healthcare workplace vary by setting, but common factors include:

- Working with people who have a history of violence or who may be delirious or under the influence of drugs or alcohol

- Lifting, moving, and transporting patients

- Poor environmental design that may block vision or escape routes

- Poor lighting in hallways or exterior areas

- Lack of emergency communication resources

- Lack of staff training and policy

- Understaffing, especially during mealtimes and visitation

- Perception that violence is tolerated and reporting incidents has no effect

How Can Healthcare Organizations Help Prevent Workplace Violence?

Preparation is the key to helping prevent healthcare workplace violence. An effective prevention program should consider these five elements:

1. Management commitment and employee involvement: To help create a safer healthcare environment for all, leadership and employees need to prioritize workplace violence prevention efforts.

2. Health and safety training: Education is the foundation of all violence prevention programs. Effective training programs help healthcare workers understand the risk factors and warning signs of workplace violence, so they feel empowered to prevent and report incidents.

3. Worksite analysis: A worksite analysis is an assessment of a work environment to find existing or potential workplace violence hazards. For example, a worksite analysis may discover that an organization has poorly lit hallways, making it harder to find an escape route in case of emergency.

4. Hazard prevention and control: Once the worksite analysis identifies an organization’s hazards, leaders need to identify potential solutions to minimize the risk of future incidents. For example, an organization could install better lighting fixtures in hallways and provide training on emergency escape routes.

5. Recordkeeping and program evaluation: Reporting and benchmarking play an essential role in ensuring violence prevention programs are effective and aligned with OSHA best practices. Healthcare leaders should evaluate their prevention programs regularly to identify and correct deficiencies.

Stericycle was founded on the belief that everyone deserves a safe and healthy world. Our team is dedicated to helping our customers protect the safety of healthcare workers and enabling them to perform at their highest level to deliver quality care and a positive patient experience.

Learn more about our Steri-Safe® OSHA Training and Compliance Solutions and how they can help your organization develop an effective workplace violence prevention plan and protect the safety of your employees.