Healthcare workers are invaluable to the well-being of communities across the country. Nurses, doctors, surgeons, paramedics, and other front line care providers are the heartbeat of the healthcare system. While their hard work is highly valued, violence against healthcare workers has increased in recent years—compromising patient safety and making an already demanding job unbearable for many.
Recent data illustrates the gravity of the situation:
- Healthcare workers make up 13 percent of the workforce but experience 60 percent of all workplace assaults.
- A CDC Vital Signs study found that the number of health workers who reported harassment at work doubled from 2018 to 2022.
- A study published in 2024 by National Nurses United found that 81.6 percent of registered nurses experienced at least one form of workplace violence during the previous year, and 6 in 10 registered nurses either changed or considered changing jobs due to violence.
Aggression and violence in healthcare facilities include physical assault, threatening behavior, and verbal abuse. Nurses are the most frequent victims, but physicians and surgeons are increasingly targeted by agitated patients, angry family members, and unauthorized visitors. These incidents often result in physical injury and long-term complications like emotional trauma, anxiety, and depression. Workplace violence also leads to higher staff absenteeism, attrition, and a decline in the quality of care provided.
Hospitals and clinics are responsible for creating a safe environment for healthcare professionals and patients. This requires a proactive workplace violence prevention strategy that combines knowledge, training, and technology to reduce the chance of emergencies and improve response times when incidents occur.
De-escalation: A Healthcare Worker’s Best Ally
Spotting warning signs of aggression and using de-escalation techniques is an important and highly effective part of workplace violence prevention. De-escalation incorporates situational awareness and verbal and non-verbal communication to defuse anger and ease tense situations before they become violent.
Several de-escalation studies found that implementing effective techniques can lead to positive outcomes for healthcare workers and patients, including:
- Preventing violent behavior
- Avoiding the use of restraints
- Reducing patient anger and frustration
- Maintaining the safety of staff and patients
- Improving staff/patient connections
- Enabling patients to manage their emotions and regain personal control
- Helping patients develop feelings of hope, and security
Empowering healthcare professionals to spot and mitigate situations before they escalate is a huge step toward strengthening staff and patient safety. However, proactive training is required so nurses, doctors, and other healthcare professionals can learn and practice the skills to react appropriately to aggressive behavior.
CENTEGIX CrisisAlert™ promotes successful de-escalation by allowing healthcare professionals to discreetly notify staff of an emergency via a wearable badge. This boosts the user’s confidence and accelerates response times when support is needed.
The Benefits of De-escalation Training
Hospitals are high-stress environments. From patients with unpredictable mental illnesses to emotional family members, many scenarios could lead to agitation, aggression, or violence. Healthcare professionals must remain calm when faced with these challenges, but that’s easier said than done.
Confidence plays a vital role in de-escalation. Training staff to recognize potential threats and react appropriately instills them with the assurance needed to stay level-headed when a patient or visitor exhibits threatening behavior. One de-escalation study found that training increased healthcare professionals’ confidence in coping with aggressive patients by 59 percent.
Penn Presbyterian Medical Center (PPMC) is a shining example of the benefits of de-escalation training. As part of its recent push toward better workplace violence prevention, PPMC has offered in-person classes that teach conflict prevention strategies, such as identifying verbal and nonverbal signs of threatening behavior.
“We recently surveyed PPMC employees about workplace violence, and 54 percent of those who attended de-escalation training in 2023 either agreed or strongly agreed that the training made them feel more equipped to safely de-escalate a situation.” -Lisa Triantos, Co-Chair, PPMC Workplace Violence Prevention Committee.
Comprehensive safety training requires a financial investment, but the long-term benefits are invaluable. Healthcare staff gain the knowledge and skills needed to play an active role in workplace violence prevention.
Top 10 Tips for De-escalation in Healthcare
Healthcare professionals experience many forms of aggressive behavior from patients. The best de-escalation approach depends on a patient’s condition and the type of behavior they’re exhibiting.
The Crisis Prevention Institute recommends the following de-escalation tips for healthcare professionals dealing with angry, hostile, or non-compliant behavior:
- Be empathetic and non-judgmental when a patient does or says something irrational.
- Respect a patient’s personal space if they’re acting irrational or threatening.
- Allow the patient time to process what you’ve said.
- Use calm nonverbal communication like gestures and facial expressions.
- Set limits when a patient is disruptive or agitated.
- Focus on feelings by letting a patient know you understand what they’re going through.
- Ignore questions that challenge your authority.
- Choose which rules are negotiable and which aren’t.
- Allow silence so the patient can reflect on their behavior.
Employing these techniques and promoting further training contributes to a culture of safety that prioritizes patient and staff well-being.
The Connection Between Nurse Safety and Patient Safety
An unsafe working environment impacts the mental health and well-being of nurses and other healthcare professionals. Threats of violence, assault, and verbal abuse can lead to burnout, anxiety, post-traumatic stress disorder, and in extreme cases, suicidal ideation. These adverse outcomes can have a trickle-down effect, compromising patient safety and reducing the quality of care provided.
Nurses are more likely to make errors or alter their approach to care if they experience ongoing fatigue, stress, or fear due to workplace violence. For example, a nurse who’s exhausted and burned out may accidentally administer the wrong medication or overlook a patient’s symptoms. They may also avoid certain patients who exhibit a pattern of aggressive behavior.
A recent survey of 7,100 healthcare workers showed the connection between workplace violence and patient safety.
- 62 percent of nurses and 53 percent of physicians reported experiencing verbal violence from a patient.
- 39 percent of nurses and 14 percent of physicians reported experiencing physical violence from a patient.
- Burnout levels for nurses and physicians were higher than the overall average for all staff.
- Higher levels of worker-reported patient safety were associated with lower odds of workplace violence and lower burnout scores.
These numbers stress the importance of violence prevention measures to increase physician and nurse safety. Findings from the survey suggest that strategies to improve patient safety culture can lead to a reduction of workplace violence and burnout among healthcare professionals.
How to Create a Culture of Safety in Healthcare
Hospitals and clinics must invest time and money in creating and maintaining a culture of safety for patients and staff. The American Hospital Association’s Patient Safety Initiative provides hospitals with data and tools for improving safety standards and offers a platform for healthcare professionals to share success stories.
Creating a culture of safety in healthcare also requires promoting the well-being and safety of nurses, physicians, and medical staff. Hospitals and clinics must implement protocols to ensure the safety of patients and the workers caring for them. The American Nurses Association (ANA) outlines safety strategies nurse leaders can use to prioritize patient safety while supporting workplace violence prevention.
Here’s a breakdown of the ANA’s strategies:
- Create effective communication protocols: Clear communication reduces the chance of errors or misunderstandings and helps staff identify potential safety issues.
- Stay current on new procedures and equipment: Staff should receive training on new procedures, such as using electronic files instead of paper documents or operating new medical equipment.
- Adhere to regulatory safety guidelines: Nurses and staff members should follow guidelines and recommendations regarding workplace violence prevention, infection control, and patient records.
- Take an evidence-based approach: Staying current on the latest research on patient and nurse safety improves prevention efforts.
- Remain diligent and proactive: Nurse leaders should remain attentive to potential safety risks and encourage their team to report incidents that could harm patients or staff.
- Think like a safety professional: Use a proven hierarchy for workplace hazards that includes eliminating risk, substituting it for a less harmful risk, or taking measures to keep people away from the hazard.
- Initiate a workplace safety response team: A multidisciplinary response team that includes staff from throughout the organization brings different perspectives and advances a culture of safety.
- Manage staff burnout: Nurse leaders must recognize signs of burnout and fatigue and support staff well-being by advocating for flexible schedules and wellness programs.
- Implement safety protocols: Strategies for violence prevention and patient safety reduce the number of injuries and aggressive incidents in hospitals and clinics.
These safety strategies are geared toward nurses but apply to all healthcare professionals working in high-stress medical environments.
The Role of Safety Technology in Workplace Violence Prevention
Innovations in safety technology help healthcare facilities reduce response times when staff experience threats or acts of violence. These tools play a crucial role in workplace safety, especially when used alongside safety protocols and training to create a layered safety plan.
The impact of technology is already visible in the education sector. Alyssa’s Law has been passed in eight states, requiring the installation of wearable duress button technology in schools. The law is named after Alyssa Alhadeff, who was killed along with 16 others during a mass shooting at Marjory Stoneman Douglas High School in 2018.
Alyssa’s father, Ilan Alhadeff, is a physician who recognizes the violence healthcare professionals face. In a 2024 op-ed by Mr. Alhadeff, he stressed the need for safety technology in hospitals and clinics, stating, “Despite their difference in purpose, healthcare facilities and schools share the unique properties of community spaces. Healthcare facilities are safe havens for those who need healing and rest within our community. No one should fear for their safety going to the doctor.”
The Joint Commission, an organization working to improve the culture of safety in healthcare facilities, has implemented workplace violence prevention requirements for health organizations.
- Organizations must manage safety and security risks through worksite analysis and environmental modifications.
- Organizations must collect information to monitor conditions in the environment, identify risk factors in vulnerable areas, and implement environmental controls.
- Staff must participate in education and training to recognize threats and employ de-escalation and intervention techniques.
- Leaders must create and maintain a culture of safety and quality throughout the organization by establishing clear lines of accountability and a standardized reporting process.
Safety technology helps hospitals and clinics fulfill these requirements. For example, digital mapping allows hospitals to view the entire facility and pinpoint the exact location of safety assets. This technology also supports the creation of effective safety plans and provides real-time incident awareness.
Healthcare workers can also carry a wearable duress button to discreetly notify responders if they need support. These devices make it easier to de-escalate a tense situation before it becomes violent.
CENTEGIX Safety Platform™: Empowering Healthcare Workers to Create a Culture of Safety
The CENTEGIX Safety Platform sets the foundation for strategic workplace violence prevention. This cloud-based solution integrates wearable duress technology, incident response, dynamic incident and asset mapping, and accessible reporting into one comprehensive safety solution.
CrisisAlert
This wearable badge features one-button activation so healthcare professionals can discreetly request help when faced with threatening or violent behavior. Locating abilities are only activated when the wearable duress button is pressed, notifying responders of the location of the incident.
CrisisAlert supports de-escalation efforts and empowers nurses and healthcare professionals to participate in workplace violence prevention for themselves, colleagues, and patients.
CENTEGIX Safety Blueprint™
Digital critical incident mapping ensures first responders are equipped to address an emergency before they arrive onsite. CENTEGIX Safety Blueprint aids in workplace violence prevention by making incidents visible in real time. It’s the only dynamic digital mapping solution that empowers healthcare facilities to:
- Reduce incident response by pinpointing the precise location of an emergency
- Understand the severity of an incident with cameras that capture an event unfolding in real time
- Visualize where safety equipment like fire extinguishers are located
- Update and customize maps and other assets to suit the facility’s needs
CENTEGIX Safety Blueprint allows hospitals and clinics to eliminate disparate spreadsheets and optimize response efforts by detailing facility floor plans and safety equipment. This supports strong collaboration with law enforcement and EMS. A customizable dashboard centralizes the storage and dissemination of all information.
Improve Safety With a Combination of Preparation and Innovative Technology
Excellent patient care is directly connected to worker safety. When healthcare professionals have the confidence and support to handle threats of violence, they’re better equipped to provide the best care possible.
Comprehensive safety plans, staff training, and innovative technology set the stage for effective workplace violence prevention. Healthcare organizations that invest in safety technology are investing in the well-being of their workers and patients.
Learn more about how CENTEGIX makes workplace violence prevention possible for healthcare facilities.
