As attacks against healthcare workers become more common, workplace safety experts are calling on regulators and employers to better protect those who care for patients.
Cases surged during the COVID-19 pandemic against a backdrop of understaffed medical facilities, rising substance abuse and an overall lack of mental health services, experts said. And while the issue has captured the attention of federal and state legislators and regulators, some say change hasn’t happened fast enough.
“We’ve seen a significant increase over the past few years,” said Mustafa Mufti, director of psychiatry at the Christiana Care Health System in Wilmington, Delaware.
Dr Mufti also notes that the pandemic’s rise in patient discontent, hospital understaffing and substance abuse rates have all contributed, and that the definition of violence has expanded to include verbal threats and intimidation. . Biological, psychological and social factors all play a role, he said.
Mufti added that restrictions on family access in hospitals during the pandemic also contributed.
“It was a period of very intense emotions,” he said.
Akin Demehin, senior director of quality and patient safety policy at the Washington-based American Hospital Association, said nurses are the workers most frequently affected by workplace violence.
“Nurses tend to be in a unique and vulnerable position given the workflow that takes place within the healthcare system,” he says.
The U.S. Bureau of Labor Statistics reports that health and social workers have the highest rates of workplace violence injuries and are five times more likely to suffer workplace violence injuries than workers in all industries. reported.
In the second quarter of 2022, there were 1,739 assaults on nurses per month, according to South Bend, Indiana-based patient safety group Press Gainey.
Perpetrators are often patients, but also include family members, visitors and colleagues, according to Press Gainey.
A National Nurses United survey in April 2022 found that 48% of hospital nurses reported an increase in workplace violence, up from about 30% in September 2021.
The American Nursing Association reported that stress was the most significant workplace risk for nurses this year, with one in four nurses being assaulted at work.
“Workplace violence in nursing is a longstanding and unresolved issue,” Ruth Francis, senior policy adviser for nursing practice and work environments at ANA, wrote in an email.
Ms Francis said the lack of consistent and accurate data is a major barrier to implementing effective violence prevention programs, especially in states without workplace violence prevention laws. She says many nurses choose not to report cases because they believe patient abuse is part of their job.
Priscilla Ross, senior associate director of federal relations for the American Hospital Association, said facilities are trying to address concerns.
“Most of our hospitals have programs and interventions in place to address workplace violence,” she said.
The Joint Commission, a hospital standards body based in Oak Brook Terrace, Illinois, has introduced a hospital certification benchmark designed to address violence. They will take effect in January 2022 and apply to all Joint Commission-accredited medical facilities and emergency access hospitals in the United States.
This standard provides a framework for workplace violence prevention programs, including training and post-incident strategies.
The US Occupational Safety and Health Administration has long sought to introduce workplace violence into medical standards. OSHA’s public comment period on medical violence ended in July.
Wayne Pinkstone, an attorney in Ogletree Deakins PC’s Philadelphia office, said the potential for OSHA standards raises the importance of the issue for employers, noting that some state laws already have compliance requirements for workplace violence. (see related article below).
Administrative regulations could also be implemented, such as increasing staffing levels and requiring workers to report threats in the workplace promptly, experts said.
Lawmakers are also working to address the issue.
One of Pennsylvania’s Rep. Madeleine Dean’s proposed bills to create a Safe From Violence Against Health Care Workers Act would deliberately assault hospital workers, similar to existing measures for assaults on airline employees. Or create criminal penalties for threats.
The bill also calls for $25 million in grants for education and training for health care facilities.
“We have to take this issue and do everything we can to protect our health care workers,” Dean said.
States Pass Laws To Better Protect Nurses
As workplace violence against nurses rises nationwide, states are taking the lead in mitigating measures.
Wayne Pinkstone, an attorney in the Philadelphia office of Ogletree Deakins PC, said many states already require health care employers to conduct risk assessments and install metal detectors and physical barriers to reduce exposure. , said it mandates the implementation of safety measures such as installing door locks.
According to the U.S. Occupational Safety and Health Administration, 11 states have laws requiring healthcare employers to develop workplace violence prevention plans. California, Connecticut, Illinois, Louisiana, Maine, Maryland, Nevada, New Jersey, New York, Oregon, and Washington.
The rise in workplace violence against nurses has accelerated the passage of Washington State Senate Bill 5454, which makes post-traumatic stress disorder compensable for nurses’ work injuries. This law will come into effect in his 2024.
Kathryn Weiss, director of government affairs at the Washington State Nurses Association, said advocates were criticizing the practice last year after several members were denied workers’ compensation despite being diagnosed with work-related PTSD. He said he had raised the issue to lawmakers.
“We just thoroughly investigated existing problems, such as staffing shortages,” she says.
In 2020, Pennsylvania Senator Maria Collett, a nurse, co-sponsored and signed a bill allowing surnames to be omitted from nurses’ work ID badges to deter stalking.
In June of this year, the Pennsylvania Legislature introduced HB 1088, which requires hospitals, long-term care facilities, and home health care organizations to establish workplace violence prevention committees to better protect their employees.
Pennsylvania legislator Ben Sanchez, a supporter of the bill, said: “Physical violence and verbal aggression in the workplace will never be tolerated, but in a healthcare setting, this is critical to quality of care and safe staffing. “It could hurt the level,” he said.
