As attacks on healthcare workers become increasingly common, workplace safety experts are calling on regulators and employers to better protect those caring for patients.
Incidents have increased during the COVID-19 pandemic due to understaffed medical facilities, an increase in substance abuse and a general lack of mental health services, experts say. And while the issue is on the radar of federal and state lawmakers and regulators, some say change isn’t happening fast enough.
There has been a substantial increase in recent years, said Mustafa Mufti, chief of the psychiatry department at ChristianaCare Health System in Wilmington, Delaware.
Mufti points out that pandemic-induced patient frustration, hospital staff shortages and rising rates of substance abuse all contribute, as does the broadening of the definition of violence to include verbal threats and intimidation. Biological factors, psychological factors and social factors all play a role, he said.
Restricted family access to hospitals during the pandemic also contributed, added Dr.
It was a very intense period of intense emotion, he said.
Akin Demehin, senior director of quality policy and patient safety at the Washington-based American Hospital Association, said nurses are the workers most often affected by workplace violence.
Just looking at the flow of work that happens within healthcare organizations, it’s really nurses who tend to be in this uniquely vulnerable position, he said.
The US Bureau of Labor Statistics reports that health care and social service workers report the highest rates of injuries caused by workplace violence and are five times more likely to suffer injuries from workplace violence than workers in all industries.
In the second quarter of 2022, there were 1,739 assaults on nurses per month, according to Press Ganey, a patient safety organization based in South Bend, Indiana.
Bullies are often patients, but they also include family members, visitors and co-workers, according to Press Ganey.
An April 2022 survey by National Nurses United showed that 48% of hospital nurses reported increases in workplace violence, up from about 30% in September 2021.
The American Association of Nurses reported that the most significant workplace hazard for nurses this year has been stress and that one in four nurses has been assaulted on the job.
Workplace violence in nursing is a longstanding, unresolved issue, Ruth Francis, the ANA’s senior policy adviser for nursing practice and the workplace, wrote via 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. Many nurses assume that patient abuse comes with their work, so they choose not to report incidents, she said.
Priscilla Ross, senior associate director of federal affairs for the American Hospital Association, said facilities are trying to address the concerns.
The vast majority of our hospitals have implemented programs and interventions to try to address workplace violence, she said.
The Joint Commission, an agency based in Oakbrook Terrace, Illinois, that sets standards for hospitals, has implemented accreditation standards for hospitals designed to deal with violence. They took effect in January 2022 and apply to all Joint Commission-accredited critical access healthcare facilities and hospitals in the US.
The standards provide a framework for workplace violence prevention programs, including post-incident training and strategies.
The US Occupational Safety and Health Administration has been trying to create a pattern of workplace violence in health care for years. An OSHA public comment period related to violence in health care ended in July.
Attorney Wayne Pinkstone of the Philadelphia office of Ogletree Deakins PC said the potential for an OSHA standard heightens the importance of the issue to employers and noted that some state laws already have compliance requirements regarding workplace violence ( see related story below).
There are also administrative controls that can be implemented, such as increasing headcount and requiring workers to promptly report workplace threats, experts say.
Federal lawmakers are also working to address the issue.
A bill to establish the Health Care Employees Safety Against Violence Act, sponsored by US Representative Madeleine Dean, D-Pa., would establish criminal penalties for knowingly assaulting or intimidating hospital personnel, similar to existing measures. related to assaults on airline workers.
The bill also provides $25 million in grants for education and training in health facilities.
We have to raise the issue and do what we can to protect healthcare workers, said Rep. Dean.
States pass laws aimed at strengthening protections for nurses
As incidents of workplace violence against nurses increase across the country, states are taking much of the leadership in mitigation efforts.
Many states already require healthcare employers to conduct hazard assessments and implement safety measures, such as installing metal detectors, physical barriers and door locks to reduce exposures, said Wayne Pinkstone, an attorney in the Ogletree Deakins office. PC in Philadelphia.
Eleven states have laws requiring health care employers to establish workplace violence prevention plans, according to the US Occupational Safety and Health Administration. They are California, Connecticut, Illinois, Louisiana, Maine, Maryland, Nevada, New Jersey, New York, Oregon and Washington.
Growing workplace violence against nurses spurred passage of Washington State Senate Bill 5454, which makes post-traumatic stress disorder a compensable occupational injury for nurses. The law takes effect in 2024.
Katharine Weiss, director of government affairs for the Washington State Nurses Association, said advocates brought the issue to the attention of lawmakers last year after several members were diagnosed with work-related PTSD but were denied compensation benefits. to workers.
It really put a microscope on pre-existing issues like staff shortages, she said.
In 2020, Pennsylvania State Senator Maria Collett, who is a registered nurse, co-sponsored a bill that was signed into law that allows nurses to omit their last names from work identification badges to avoid harassment.
In June of this year, Pennsylvania legislators introduced HB 1088, which would require hospitals, long-term care facilities, and home health care agencies to develop workplace violence prevention committees to better protect workers. workers.
Physical violence and verbal abuse in the workplace is never acceptable, but in a health care setting, it has the potential to compromise quality of care and safe levels of staffing, said Pennsylvania State Representative Ben Sanchez, a supporter of the bill.
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