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Halting assaults: Strategies to prevent workplace violence

Nurse Leader Insider, October 26, 2007

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According to the National Institute for Occupational Safety and Health (NIOSH), healthcare workers, especially those providing emergency and psychiatric care, have a particularly high risk of work-related assault, with nurses being in the most precarious position, as they administer direct patient care. In fact, NIOSH reports an average of 69,500 assaults against nurses annually.

What are the risk factors for violence?

Although the risk factors for violence vary from hospital to hospital depending on location, size, and type of care, common risk factors for hospital violence include the following:

• Working directly with volatile people, especially if they are under the influence of drugs or alcohol or have a history of violence or certain psychotic diagnoses
• Working when understaffed, especially during meal times and visiting hours
• Transporting patients
• Long waits for service
• Overcrowded, uncomfortable waiting rooms
• Inadequate security
• Lack of staff training and policies for preventing and managing crises with potentially volatile patients
• Unrestricted movement of the public

Prevention strategies and safety tips

To terminate violence in hospitals, nurse managers should develop safety and health programs encouraging staff involvement in hazard prevention. Although risk factors for violence are specific for each hospital and its work scenarios, managers can follow general prevention strategies, such as developing emergency alarms, monitoring systems, and security devices. Individual nurses and other healthcare workers should always be alert and cautious when interacting with patients and visitors. Some helpful safety tips are as follows:

• Watch for signals that may be associated with impending violence, such as anger expressed verbally and threatening gestures
• Maintain calm behavior that helps diffuse anger
• Evaluate each situation for potential violence when you enter a room or begin to relate to a patient or visitor
• Don't isolate yourself with a potentially violent person
• Don't let a potentially violent person stand between you and the door
• Call security for help

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