Leveraging Technology to Improve Nurse Safety
By Matt Phillion
Connecticut recently put forth legislation to improve the safety of its healthcare workers following the death of a visiting nurse in October 2023. The laws, which went into effect in October 2024, include:
- Enhanced training for healthcare workers to identify high-risk patients and situations
- Security grants for agencies to help fund security escorts for workers visiting potentially dangerous locations
- Workplace safety requirements employers must implement, such as violence prevention protocols, panic alert systems, and comprehensive patient risk assessments
Changes such as these push hospitals and home health agencies to prioritize and implement effective measures to protect nurses from danger.
“There are things everybody knows but nobody wants to say out loud,” says Rom Eizenberg, CRO and head of product innovation with Kontakt.io. “Being a nurse is one of the most dangerous jobs. The frequency of risk in the workplace is greater than flying an F-14 for the Navy. Nurses are always discussing violent events and fears for their safety—why aren’t we doing anything about it? It’s not a new problem, and while some folks have said COVID changed things in terms of workplace safety, it’s always been an issue.”
Healthcare situations can, by their nature, be a hotbed for risk, Eizenberg explains.
“If you look at employee safety data from the last decade, it’s always been an issue,” he says. “Patients can act violently, families will fight, and the ED is a place where all manner of society meet.”
Workplace violence isn’t a new problem and solving it does not require a technological breakthrough, he explains.
“It’s not about adding AI. It requires that this topic becomes a focus area for health systems, which it is now,” says Eizenberg.
On everyone’s radar in healthcare, Eizenberg goes on, is the high attrition of nurses and connected to that, the impact nurses feeling unsafe in the workplace has.
“During COVID, between 8% and 11% of nurses left the profession. It takes years to train a new nurse,” he says. “We’ve seen the labor shortage, and that leads to other impacts; with a shrinkage in the workforce, salaries increase, and people jump to different roles more frequently. You fight this attrition by making them feel more comfortable in the workplace. And what makes them feel comfortable? One of the top factors is workplace safety.”
The ROI of safety
It can sometimes be a challenge to convince the right people that the return on investment that comes with safety improvements is worth the buy-in, Eizenberg explains.
“Does it have ROI? They see it as an expense with no measurable return,” says Eizenberg. “But there is soft ROI. You might hear from the CFO perspective: sure, the staff are happier, and there are fewer resignations, but you can’t prove a correlation. But in the market today, we see a high awareness of the need to do better and fix some of these problems. I also suspect the weight of the general public perception shifts the focus as well.”
Kontakt.io’s solution is a badge capable of triggering a silent alarm alerting staff when a nurse is in distress.
The thin badge has a discreet button on the back which can be triggered to alert other staff when the nurse is at risk. The staff and security team can find the nurse in real-time and access detailed reports on the Staff Safe app.
“The alarm is coupled with location, so we can know if a nurse has had to retreat from a patient and where,” says Eizenberg. “Maybe they met an aggravated patient in the hallway and had to walk into an empty patient room or a utility closet. Hospitals are like mazes, lots of staircases, lots of doors.”
The silent alarm sends out a distress call with a room-specific location.
“Usually when a nurse is in trouble, usually the first responders aren’t security—it’s their peers,” says Eizenberg. “Our goal is, at the hospital level, to remember we’re not the police force. We want to de-escalate the situation.”
But de-escalation is the second phase of measures, Eizenberg explains. It begins with technology that allows for location awareness that makes staff feel safer knowing they can call for help. This goes hand in hand with training for those de-escalation strategies, such as flooding the room with personnel to flip the ratio from one angry patient and a nurse to four or five clinicians in the room together.
The badges are unobtrusive—half the size of a credit card—so as not to aggravate or alert the person threatening the nurse as they activate the silent alert to other staff.
“Coupled with the right training, you have a solution to a real-time problem, which builds confidence and offers peace of mind,” says Eizenberg.
The badges can have secondary benefits as well, he notes.
“We’re not tracking the location of nurses but can look at mundane tasks like patient roundups to help follow the intervals staff check in on patients,” he says. “There’s consensus that the amount of time spent with a patient at the bedside directly correlates with clinical outcomes. Patients who spent more quality time with clinicians get home faster and have better outcomes.”
This also helps sell safety as an ROI factor, Eizenberg notes. If patient throughput is a lever to pull to influence revenue, better patient throughput can be a selling point for the expense of safety.
“Length of stay is a key metric for the CFO. We want better clinical outcomes—we’re not selling tires, we make people healthy—but how can we connect this all together?” says Eizenberg. “If a nurse has a duress badge that can be tracked, we can now automate an EHR entry to know the nurse walked into this patient room and spent five minutes there and also know how long it has been between visits to the room. We reduce the cost of documenting roundups. Another reason nurses are unhappy is the administrative work that gets in the way of taking care of patients. So, we create this automation as part of a duress badge that increases staff safety and improves outcomes.”
By investing in nurse safety, the organization improves patient safety, and potentially length of stay, improves documentation, and increases the employee experience overall.
“I can spend time explaining that safe nurses are not a soft ROI, but the best way to address this gap to leadership is to couple safety and positive experience with efficiency,” says Eizenberg.
Reactions from the field
Eizenberg says that beyond just looking at surveys or other satisfaction results, his team keeps an eye on nurse message forums to find out what nurses think of the results of the duress badges for safety.
“There’s been incredibly strong feedback but one of the most surprising things is they appreciate their employer. We’ll see them say things like ‘It’s nice to work in a place where they care about you.’ It’s such a powerful statement,” he says. “In a typical 250-bed hospital we see two real duress events a day. When people are given a tool and have confidence that it works, it’s put to good use and the results are significant. We’ve seen quantifiable results like fewer sick days taken in correlation to using the badges.”
Eizenberg sees several directions that the industry could continue to improve nurse safety through access to alerting systems.
“I think the future around safety, not just from violence but around clinical events as well, is centered on a notion of Big Brother,” he says. “It’s a negative term but I’m from a generation where I didn’t want to be tracked. Younger generations think, ‘There’s nothing interesting to see so knock yourself out.’ Things like audio in the clinical space that would enable you to talk, like an Alexa in the room, that is activated when your tone of voice gets louder, or someone says, ‘I need help!’ And just saying it out loud sends that signal. Nobody will want to do it just for safety, but if it can also help with dictating notes to the health record and cut down on administrative tasks to create more efficiency, there’s more use and ROI there.”
It creates a more hands-free, functional environment by making the environment aware, he says.
“Let’s not call it Big Brother, but rather conditional awareness, the patient room of the future,” says Eizenberg. “It will drive efficiency, increase patient safety, and improve care delivery.”
Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.