New Survey Sheds Light on Workplace Violence in Healthcare Settings

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By Christopher Cheney

A recent survey found that 40% of healthcare workers had experienced workplace violence in the past two years.

Healthcare organizations carry a heavy workplace violence burden, with about three-quarters of U.S. workplace assaults occurring in healthcare settings, according to the Occupational Safety and Health Administration. Workplace violence is prevalent in emergency departments—78% of emergency physicians have reported being targets of workplace violence in the prior 12 months.

The recent survey, which was conducted by Premier Inc. and the Agency for Healthcare Research and Quality, features data collected from 672 clinical healthcare workers, healthcare administrative workers, and healthcare security personnel. The survey was conducted from Feb. 1 to April 14.

The survey includes several key data points:

  • Workplace violence is most common among nursing staff, and more than half of incidents involved combative patients as perpetrators
  • Most workplace violence incidents occurred when healthcare workers were explaining or enforcing an organizational policy, or when healthcare workers provided an update on a patient’s condition to a patient or a patient’s family members
  • For female survey respondents, 50% of workplace violence incidents involved emotional or verbal abuse and 50% of incidents involved physical or sexual abuse
  • For male survey respondents, 62% of workplace violence incidents involved physical abuse and 38% of incidents involved emotional or verbal abuse
  • Nearly two-thirds of survey respondents who experienced workplace violence identified themselves as bedside nurses
  • The majority (62%) of workplace violence perpetrators were men, 37% of perpetrators were women, and 1% of perpetrators were non-binary
  • Two-thirds of survey respondents reported that their workplace violence perpetrator was not noticeably or confirmed to be under the influence of drugs or alcohol
  • In workplace violence incidents involving combative patients: 62% of survey respondents reported being scratched, bit, and hit; 21% of survey respondents reported that the patient threw objects; 14% of survey respondents reported sexual abuse; and 1% of survey respondents reported being shot by a patient
  • In workplace violence incidents reported to law enforcements, 45% of survey respondents reported that law enforcement was responsive to physical or sexual violence incidents and 22% of survey respondents reported that law enforcement was responsive to verbal or emotional abuse incidents
  • Mental illness was cited as the top factor in workplace violence incidents by 27% of survey respondents
  • Drugs and alcohol were cited at the top factor in workplace violence incidents by 24% of survey respondents

Workplace violence in healthcare settings has several negative consequences, according to the survey report. “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.”

The survey report expresses support for the Safety from Violence for Healthcare Employees (SAVE) Act of 2023, which was introduced in the U.S. House of Representatives in April. “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.”

The findings of the survey are significant, Soumi Saha, PharmD, JD, senior vice president of government affairs at Premier, told HealthLeaders.

“It’s very concerning as violence in the healthcare setting continues to rise and, according to our survey, more than half of all respondents felt that these incidents had increased during their tenure. What is unique about Premier’s survey is that we heard directly from healthcare employees regarding their experiences and the need for change moving forward to address burnout, retention, and recruitment. Furthermore, workplace violence incidents aren’t considered a federal crime, which is why Premier continues to support bipartisan legislation like the SAVE Act to provide enhanced legal protections for healthcare workers,” she said.

Healthcare workers and their organizations need to take a proactive approach to addressing workplace violence, Saha said. “According to the survey, more than half of the respondents dealt with a combative patient. We believe healthcare workers need to maintain open communication with their peers, teams, and leaders regarding access to workplace violence prevention programs, de-escalation training, and other resources that can help them stay safe while providing a calm and safe place of healing for all patients. The key is that addressing workplace violence requires a proactive approach that creates a safe space for workers to report incidents without fear.”

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.