Workplace violence in healthcare is an international issue. The numbers are staggering:

1. Two nurses are assaulted every hour in the United States (Press Ganey).
2. 61% of staff have reported physical abuse (Emergency Nurses Association).
3. One out of four nurses have been assaulted on the job (American Nurses Association).
4. 85% of the assaults against staff are committed by the patient receiving care (International Association for Healthcare Security and Safety). 

Violence against caregivers is not a matter of if it will happen, but when. It’s become so common that it’s forcing nurses to leave the industry. Healthcare organizations are feeling the repercussions in their ability to recruit and retain talent, as well as improve patient satisfaction and the bottom line. 

How security teams and executive leaders prioritize safety can make a difference. Understanding the elements of a successful workplace violence prevention program as well as some of the innovative technologies that can be used to mitigate the risk of violence is a first stepping-stone. 

Consider bringing in an outside consultant to conduct a proactive, objective and comprehensive assessment of an existing program. This sends a message to staff that their leaders want to understand the issues impacting safety. An experienced consultant will ask: 

• Can you demonstrate management’s commitment to support your violence prevention program?
• Do you have an easy-to-use incident reporting process?  
• Are staff informing leadership about incidents and their safety concerns? 
• Do you have a workplace violence committee? Are the right people and disciplines part of the committee? 
• Do you know your data? Where are the incidents occurring? Who is at most risk of violence? 
• Are you providing training and education on how to identify and manage aggressive behavior? Does your staff support the training program? 
• Do you provide resources to support staff who experience a workplace violence incident? 
• Have you conducted a comprehensive review of your overall workplace violence prevention program? 
• Have you implemented any evidence-based technology or improved the physical environment to mitigate incidents of violence? 

A healthcare facility with a mature and professionally managed workplace violence prevention program should be able to answer “yes” to all these questions. The reality is that most organizations are just beginning to focus on supporting the infrastructure and putting the systems in place to create a comprehensive workplace violence prevention program. 

However, there is not just one mitigation strategy that will reduce violence in healthcare. The best strategy for leaders is to identify their risk points and evaluate the solution(s) that would mitigate their biggest risk. Fortunately, there are numerous technologies that can improve staff safety and have been proven to reduce incidents of violence. 

Weapons screening 

In 2023, there were 658 mass shootings and over 42,000 Americans were killed by gun violence. As these events rise, weapon screening solutions such as handheld metal detectors, walk through metal detectors, video-based weapon screening and advanced screening using AI, have become a central focus for many healthcare organizations. However, I often caution leaders from deploying a weapon screening solution if their facility has major access control issues. You must first be able to control entry points to successfully deploy a weapon screening solution. Healthcare executives should consider their needs, culture and climate of the surrounding community as well as the financial impact of purchasing and appropriately staffing a weapon screening station. 

Risk assessment 

Risk management is the practice of identifying risk to determine if you can take an action to transfer, reduce, eliminate or accept the risk. Traditionally, risk assessments have been completed manually using an Excel spreadsheet or security vulnerability analysis spreadsheet. Today, there are enterprise risk assessment tools designed to collect and analyze data using analytics and statistical models to create a more accurate depiction of risks. These risk assessment tools can be used to identify access control and network vulnerabilities that could threaten both patient and organizational information. 

Duress buttons 

An International Association for Healthcare Safety and Security Foundation study identified that 89.3% of healthcare worker participants have access to panic buttons, however these are often hardwired to nurse’s stations. And a study by the Emergency Nurses Association identified that 82% of physical violence incidents occur inside a patient’s room, where an outside panic button would not be reachable. Even panic buttons inside the room may be out of reach in a sudden situation. 

To provide a greater sense of safety for staff, many organizations are deploying wearable duress buttons, powered by real-time locating system (RTLS) technology. When staff push the duress button on their personal badge, an alert is sent to nearby colleagues and security teams. The duress buttons and real-time notifications help reduce response times, frequency of restraints and frequency of assaults against staff. 

When evaluating solutions, healthcare organizations should consider maximizing any existing RTLS infrastructure used for asset tracking or nurse call systems. Nurse call systems specifically are a great starting point because many are automated by RTLS—the badge that staff already wear for automated nurse call can easily be turned into a duress button—minimizing workflow disruption. 

Analytics 

Security leaders know that data drives every decision people make, including where to spend time and money. To garner the most value, the data must be searchable, and the system should be able to generate detailed dashboards and reports that allow for the development of actionable tasks. For example, security leaders should be able to search by campus, department, victim type, employee occupation, aggressor type, injury type and if the victim filed a police report. Spell checking and interfacing with the active directory database as well as the admission, discharge and transfer database should be considerations too. 

Healthcare security leaders have an important role to play in preventing violence against caregivers. Security leaders all must actively support the workplace violence prevention program and be able to influence senior leaders when it comes to evaluating new technologies that mitigate the potential of violence.