Patient Violence

July 23, 2018 | Healthcare Risk, Quality, & Safety Guidance

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​Patient violence and aggression is pervasive in healthcare settings and puts patients, staff, and the healthcare organization at risk.

Writing about patient violence, one physician remarked, "Sometimes the most dangerous thing in the hospital isn't the potential for medication mistakes, or medical errors—it's the patients." (Brewer)

According to 2015 data from the U.S. Department of Labor, patients were the cause of 80% of all nonfatal occupational injuries to healthcare workers that involved another person and resulted in days away from work (BLS​ ​"Table R3"). Countless other verbal and physical assaults by patients are often not reported by healthcare workers, especially when the incident doesn't result in injury.

Event reports submitted to ECRI Institute PSO show that doctors, nurses, ancillary staff, and security officers working in ​​healthcare settings are greatly challenged in managing patients who become violent or threaten violence.

Consequently, in the five years (2014 -2018)​ that ECRI Institute has compiled a list of the top 10 patient safety concerns confronting healthcare organizations, patient violence has made the list each year. The list has sometimes focused attention on patient violence by specifically addressing better management of the behavioral health needs of patients who exhibit psychiatric illness or emotional agitation during an acute-care stay.

Some of the many consequences from patient violence include:

Risk managers can support their organizations in addressing the pervasive problem of patient violence and ensuring the safety and well-being of staff, patients, and visitors. OSHA and others have underscored the importance of a multipronged approach to curtail workplace violence. This guidance article describes such approaches, which include the following:

​​Although the information in this guidance article is specific to hospitalized patients, many of the recommendations also apply to nursing homes, where the number of resident assaults of staff resulting in injuries and days away from work are nearly double the rate of patient assaults on staff in hospitals (BLS "Table R8"​). Staff who provide home care are also at risk for patient violence;...

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