Strategies for Reducing Patient Violence Experienced by Healthcare Workers in Emergency Department and Inpatient Settings

Acts of patient violence (e.g., hitting, spitting, biting, scratching, hair pulling) are pervasive in healthcare settings and put staff (i.e., doctors, nurses, ancillary staff, security officers), patients, and the healthcare organization at risk. Patient violence is a form of workplace violence, defined by the National Institute for Occupational Safety and Health as “violent acts directed toward persons at work or on duty. " In addition to actual physical assault, the agency includes verbal threats and threatening body language in the definition. 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. The causative rate for these injuries may actually be higher because healthcare workers often do not report assaults by patients. Underreporting is a problem that may cause facilities to limit their attention to developing strategies for preventing violent behavior.

The many consequences from patient violence include:

Multiple factors can trigger patient violence, including the following:

Other environmental features of the care setting can allow for patient violence, including these setting-related risks:

An organization's policies, or the lack thereof, can also allow patient violence to arise. OSHA guidelines list the following examples that put an organization at risk:

Several regulatory and accrediting agencies provide guidance/recommendations on preventing patient violence. In addition to the federal government, some...