Addressing workplace violence against nurses and other healthcare workers requires a multi-pronged approach, and urgent action is needed from multiple stakeholders, seven nursing leaders wrote in an Aug. 23 Health Affairs report.
In the last few years, reports — anecdotal and data-based — of violence in the healthcare setting have become disturbingly common. Last fall, Press Ganey released survey findings showing an average of two nurses are assaulted every hour, which translates to about 57 assaults per day and 5,217 per quarter.
"We write today, as psychiatric mental health nurses and workplace violence and nursing workforce researchers to express our alarm," the nurse leaders wrote. "Our nurse colleagues aren't safe at the bedside. The American Psychiatric Nurses Association reports that fewer than two-thirds of nurses report feeling either safe or very safe at work."
Tackling the issue will require coordination among law makers, health regulators, healthcare organizations and data systems, as well as those in the nursing practice and education sector, according to the report, which laid out the following steps as "key actions" to protect all nurses and staff from violence:
- Pass federal legislation: The time is long overdue to enact the Workplace Violence Prevention for Health Care and Social Service Workers Act as law, nurse leaders say. The legislation was introduced in 2019 and would direct OSHA to require healthcare and social service employers to develop and implement comprehensive workplace violence preventions.
- Focus on quality indicators that elevate efforts to protect staff: Accrediting agencies should give more weight to the effects of violence on healthcare workers, according to the report. "For example, the quality and safety standards for psychiatric facilities currently in use by The Joint Commission do not include an indicator of patient assault; nor has any kind of clear mandate for nurses to report violent incidents been included in unit-level violence prevention plans and trauma-informed de-escalation training programs," the authors said.
- Strengthen data systems to monitor staff exposure to aggression: Healthcare organizations should invest more efforts in measuring aggressive events and the specific factors involved in worker exposure, such as patient type and severity, and staff ratios.
- Improve reporting on workplace violence: Healthcare organizations should prioritize the building of safe work cultures that encourage the reporting of violent events and the reduction of violent acts.
- Hold educational institutions accountable for teaching about standards to protect nurses and staff: Nursing education should be updated to ensure students are taught about "the intentional action they must take to recognize, document and intervene to protect staff safety." Accreditors of pre-licensure programs such as the Association of Colleges of Nursing should provide standards related to educational content on this topic.
The report was written by Linda Beeber, PhD; Kathleen Delaney, PhD, APRN; Emily Hauenstein, PhD, RN; Joanne Iennaco, PhD, APRN; JoEllen Schimmels, DNP; Daryl Sharp, PhD, RN; and Mona Shattell, PhD, RN. Read more about the authors here.