COMMENTARY

Workplace Violence in the Healthcare Setting

Dan Hartley, EdD; Marilyn Ridenour, BSN, MBA, MPH

Disclosures

September 13, 2011

Editorial Collaboration

Medscape &

In This Article

Workplace Violence Circumstances

The NEISS-Work follow-back study data indicated that more than 40% of interviewed healthcare workers were injured while working in psychiatric or behavioral units, almost 20% were injured in geriatric units, and just under 10% were working in the emergency department when they were assaulted.[6] This result is consistent with findings from several other publications that reported high rates of physical and nonphysical violence in emergency departments, psychiatric/behavioral units, and long-term care or nursing homes.[11,12,13] Perpetrators of this violence were mostly patients, their families, and visitors.[2,14] Patients tended to assault healthcare workers while the healthcare worker was addressing their needs.[6] Working in isolated areas or one-on-one situations with patients places healthcare workers in a position of increased risk for assault.[13,15,16] Although assaults can occur anywhere in a healthcare facility, many take place in patient rooms, emergency department cubicles, or common areas.[6]

Typology of Workplace Violence

Healthcare providers should be aware of the different types and sources of workplace violence. The California Division of Occupational Safety and Health developed a typology of workplace violence that describes the relationship between the perpetrator and the target of workplace violence.[17,18,19] Type 1 -- criminal intent -- is violent acts by individuals who have no connection with the workplace other than to commit a crime (eg, robbery). Violence directed at employees by customers, clients, patients, students, or any others who have a lawful relationship with the business is considered type 2: customer/client workplace violence. Type 3, which is worker-on-worker violence, consist of acts by present or former employees that are directed toward coworkers, supervisors, or managers. Type 4 -- personal relationship violence -- is perpetrated by someone who is not employed by the business but has a personal relationship with an employee. Types 2 and 3 are the most common types of workplace violence in healthcare settings.

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