By Ann Scott Blouin, RN, PhD, FACHE
Executive Vice President of Customer Relations
It’s a sad reality that Americans are growing accustomed to encountering violence on the highway, at movie theaters and in schools.
Increasingly health care staff are becoming victims and observers of this growing problem while they’re working.
The Joint Commission just launched a workplace violence prevention portal to support health care organizations in preventing, preparing for and mitigating the impact of workplace violence. The violent situations occurring across our country spill over into our emergency departments (EDs), behavioral health settings and elsewhere. In a matter of seconds, your patients, staff and visitors can become victims in these frightening and often devastating situations.
In seeking submissions from colleagues and professional associations on addressing violence in healthcare settings, we wanted to provide a compendium of resources through our new portal for easy reference on this somber topic.
Nurses, Nursing Assistants at Increased Risk
Though violent incidents can affect everyone from the chair of surgery to a patient’s visiting grandmother, the nursing profession encounters these frightening situations most frequently. Alarmingly, 80% of nurses don’t feel safe in their workplace, according to a 2009 study (Peek-Asa et al, 2009)
Even when injuries aren’t fatal or very serious, these incidents can exacerbate the nursing shortage because the result can be early retirement, disability or, at the very least, missed work days.
The health care environment, especially hospitals, actually present a risk factor. The public moves relatively unrestricted in the hospital, especially the ED. Hospitals are becoming popular “criminal hold” locations and may be targeted because of the perceived availability of drugs or money.
Whether urban or rural, the sad reality is that the possibility of an active shooter in the hospital is becoming more common. Between 2010 and 2014, The Joint Commission received reports of 19 shootings in our accredited healthcare settings, resulting in 27 fatalities. It is unclear whether those numbers are going to decrease anytime soon.
Health care organizations s have risen to the occasion and created crisis prevention and management plans. These days, it’s a must to incorporate active shooter incident planning into health care facility emergency operations plans.
Active shooter drills dominate association conferences in every specialty. In 2015, the Emergency Nurses Association orchestrated a surprise mass casualty drill (Note: This is a link to YouTube) at its annual conference. Sadly, a few attendees tested their skills several months later while treating victims of the Pulse nightclub shooting in Orlando.
Many organizations’ innovative practices and protocols can be found in our new online resource center for addressing workplace violence; however there’s no “one-size-fits-all” solution.
What we have learned is that the answer is far more complicated than just “call security.” In fact over the past 11 years of data, we’ve learned that 23% of hospital shootings (frequently in the ED) involved the perpetrator taking a security or police officer’s gun, according to internal data from The Joint Commission’s Office of Quality and Patient Safety.
Need for Collaboration
Realizing that we’re all accountable for managing—ideally, preventing—instances of workplace violence from occurring is truly the first step.
This collaboration may save our lives and those of our patients and colleagues. Please take the time to review materials from government agencies like OSHA and the FBI, state health departments, and professional associations like the American Nurses Association and the American Society for Healthcare Risk Management, all featured on our web resource center.
We recognize that workplace violence doesn’t occur only in the acute care setting. The Joint Commission’s workplace violence prevention resource center is very much a work in progress. We would appreciate learning about your experiences in home care, behavioral health, nursing care centers/long term care and ambulatory care. Please share your ‘lessons learned’ and, importantly, your suggested strategies for preventing future incidents.
Please submit your innovative practices to curtail workplace violence to Wpv_info@jointcommission.org