As I developed a training program on violence prevention, I reflected on a scenario I’ve witnessed many times in my career. A resident who had been physically aggressive toward aides and nurses got sent to the hospital only after he hit the attending physician.
Situations like this send the message to nursing department staff that they aren’t important, and that violence is just part of the job. That attitude explains why nurses are estimated to report violent behaviors just 30% of the time1.
Instead of accepting aggressive behaviors as normal, facilities would be wise to approach then as anomalies that can and should be addressed. As research indicates,2 aggression toward workers decreases staff satisfaction and increases burnout. Violence prevention efforts reduce turnover costs and improve morale, and result in fewer lawsuits and a reduction in worker’s compensation claims.
Violence prevention programs
According to the Occupational Safety and Health Administration, a violence prevention program has several key elements:
- Management commitment and employee involvement
- Worksite analysis
- Hazard prevention and control
- Training and education
- Record-keeping and evaluation of program
The thrust of such programs is to support and encourage staff to report events so that there can be an accurate evaluation of the circumstances contributing to violence. Using the information gleaned from this analysis, adjustments are made to the environment and workers are trained to handle aggressive behaviors. These steps are followed by reevaluation and readjustment as needed.
The efforts can be remarkably effective. In one hospital-based program,3 Operation Safe Workplace, the incidence of violent behaviors was reduced by 55%! While hospitals have different factors contributing to these problems, such as a younger, more physically able population, there are many aspects of a long-term care environment that could be adjusted to reduce the likelihood of aggressive behaviors.