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Premier Survey Reveals Key Insights on Workplace Violence Incidents in Healthcare*

Key takeaways:

  • A Premier survey revealed 40 percent of healthcare workers experienced an incident of workplace violence in the last two years.
  • According to the survey, violence occurs most frequently among nursing staff at the hands of men between the ages of 35-65. More than half of all reported incidents were at the hands of combative patients.
  • Premier survey insights can be used to inform health system decision making regarding workplace violence, inform mitigation and prevention strategies and help advance legislation designed to criminalize perpetrators of violence in healthcare settings.

According to Premier’s survey, forty percent of healthcare workers have experienced an act of workplace violence in the last two years, according to a new survey conducted by Premier in conjunction with the Agency for Healthcare Research and Quality (AHRQ).

Percentage of Workforce Directly Involved in Workplace Violence in the Last Two Years

Among those who responded that experienced workplace violence, they indicated the incidents occurred most often while explaining or enforcing an organizational policy, or while providing an update on a patient’s condition to the patient or to the patient’s family members.

Women responding to the survey reported that incidents of workplace violence were evenly split between emotional or verbal assaults (50 percent of women responding) and physical or sexual abuse (50 percent). Men responding to the survey were more likely to experience physical abuse (62 percent) versus verbal or emotional assaults (38 percent).

More than half of all respondents felt that workplace violence incidents had increased during their tenure.

Breaking down incidents based on role, 60 percent of those who experienced violence identified as a bedside nurse. Thirty-four percent of the population of nurses reported emotional or verbal violence, while 66 percent experienced physical or sexual violence.

Workplace Violence Experienced by Nurses Compared to All Hospital Roles

Profile of a Perpetrator

Sixty-two percent of survey respondents indicated perpetrators of workplace violence were men, versus 37 percent who identified their perpetrator as female and one percent who identified their perpetrator as non-binary (percentages rounded).

Most perpetrators were between the ages of 36-65 years of age (reported by 61 percent of respondents), while 27 percent said their perpetrator was under the age of 35.

Most respondents (67 percent) said their perpetrator was not noticeably or confirmed to be under the influence of drugs or alcohol.

Among survey respondents who provided detail about the workplace violence they experienced, 51 percent indicated they dealt with a combative patient. While dealing with a combative patient, 62 percent of respondents endured scratching, biting and hitting; 21 percent indicated the patient threw objects; 14 percent indicated sexual assault or harassment; and one percent indicated they were shot by a combative patient using a firearm.

Respondents' Experience with Combative Patients

Law Enforcement Response
When dealing with incidents against healthcare workers, many of the incidents were not escalated to law enforcement, since many acts of verbal abuse, threats and intimidation generally do not have the same criminal status, as they are for police officers, paramedics or emergency medical technicians (EMTs).

Experience of Law Enforcement Responsiveness Among Victims of Verbal/Emotional Assaults
Experience of Law Enforcement Responsiveness Among Victims of Physical/Sexual Assaults

Among those who experienced a workplace violence incident that was reported to law enforcement, 45 percent indicated that law enforcement was responsive to the physical or sexual violence reported and 22 percent indicated law enforcement was responsive to the verbal or emotional violence reported.

Causes of Workplace Violence

When survey respondents were asked to rank the top contributing factors to acts of workplace violence:

  • 27 percent of survey respondents ranked mental illness as the top factor.

  • 24 percent of survey respondents indicated drugs and alcohol.

  • 18 percent of survey respondents indicated other patient-related factors were contributing causes.

What They’re Saying: Recent Legislation

This year, the bipartisan Safety from Violence for Healthcare Employees (SAVE) Act of 2023 (H.R. 2584 / S. 2768) was reintroduced.

This legislation would give healthcare workers the same legal protections against assault and intimidation as aircraft and airport workers. It would also establish a federal grant program at the Department of Justice to augment hospitals’ efforts to reduce violence by funding violence prevention training programs, coordination with state and local law enforcement, and physical plant improvements, such as metal detectors and panic buttons.

Premier is Committed to Helping Members Prevent Workplace Violence

Premier continues to actively support legislation, like the SAVE Act, and believes that the hardworking staff at our hospitals and health systems deserve enhanced legal protections that criminalize intimidation and violence against healthcare workers. If passed, this legislation could create a federal standard that would help ensure consistent application of these protections across the country.

Additionally, Premier supports the grants that would be available as a result of the SAVE Act, allowing hospitals and health systems to bolster programs designed to prevent and reduce incidents of workplace violence. These grants would also be used for training hospital personnel, coordinating with state and local law enforcement and purchasing equipment or technology that will assist in creating a safer environment. Premier also supports the recently launched National Healthcare System Action Alliance to Advance Patient Safety, a public-private collaboration to improve both patient and workforce safety to move toward zero harm in healthcare.

Premier is helping hospitals and health systems gain access through our contracting process to devices that can help increase their security efforts. For example, one item is a scanning device that can indicate the type and location of a weapon on an individual before they enter the hospital or health system.

Finally, Premier is working with clinicians, hospitals and health system leaders to address workforce issues through the development of a PINC AI Workforce Collaborative. Part of this collaborative's work will be addressing the drivers and impacts of labor shortages, key challenges to maintaining and supporting a resilient workforce and looking at future models of care delivery. As part of this effort, a deep dive into incidents of workforce violence is expected to occur, including the impact on healthcare workers and strategies to mitigate, prevent and reduce incidents across all areas of healthcare. Furthermore, the collaborative will help identify best practices to educate healthcare employees about policies, procedures and mitigation strategies in place to help create a safe working environment.

Premier Workforce Management Solutions

Healthcare workplace violence can potentially contribute to burnout and can lead to staff turnover, exacerbating workforce shortages. In addition to helping health systems implement strategies to mitigate workforce violence, Premier’s PINC AI Workforce Management solution helps health systems compare their performance against peers, improve staff engagement and satisfaction, optimize labor costs and implement a structured, sustainable workforce management (WFM) program.

The Bottom Line

Healthcare workers experiencing workplace violence may suffer physical and psychological trauma. These acts of violence can also disrupt patient care when providers fear for their personal safety or are distracted by disruptive patients or family members. Having a strong prevention and mitigation strategy in place is critical in the prevention and reduction of incidents of workplace violence.

Premier is committed to sharing actionable data and providing evidence-based guidance to help providers plan their strategies to mitigate all types of workplace violence.

It’s important to remember that workplace violence is complex. Healthcare organizations should consider a multi-pronged approach to create effective solutions that address all forms of violence and can help build a foundation to support a culture of safety where healthcare professionals, patients and visitors feel safe.

*Survey Methodology
Premier conducted the survey of healthcare workers from Feb. 1 – April 14, 2023. Approximately 672 individuals responded, representing a range of individuals working in a healthcare setting from clinical care and administrative roles to security personnel. Of the 672 respondents, 362 identified as women. Not every respondent answered every question.

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