The American Nurses Association reports that one in four nurses has experienced workplace violence. In the second quarter of 2022, more than 5,200 nurses were attacked in healthcare institutions nationwide.
Meanwhile, research from the Emergency Nurses Association shows that seven in 10 emergency room nurses report being kicked or punched while at work. This problem is exacerbated by social and political pressures and other issues surrounding overcrowding, long wait times and limited staffing.
All professional nursing organizations are addressing this problem. The American Nurses Association, American Organization of Nurse Leaders, Emergency Nurses Association and The Joint Commission have established standards and provided toolkits to reduce workplace violence.
“A workplace culture that values silence over safety is just another form of violence,” the ANA said.
Zero tolerance of Workplace violence is a must, says Rhonda Collins, DNP, RN, chief nursing officer at Kontakt.io, a healthcare analytics provider. Collins has been a nurse and hospital director for more than thirty years. She also served as chief nursing officer at Vocera Communications, where she continued her mission to adapt technology to the hospital’s real-world needs.
Healthcare IT news recently spoke with Collins to share her thoughts on workplace violence affecting nurses, and to discuss causes and possible solutions – including the key that technology can play.
Q. As a registered nurse, you have served both on the front lines and in leadership roles at major hospitals. How have you dealt with the issue of workplace violence in these roles?
A. Early in my career, the expectation was that nurses would control the behavior of their patients. There was this idea that if I couldn’t control my patient, I couldn’t carry out my responsibilities effectively. That created an environment of reluctance to report events, which led to both an increase in the number of incidents and an increase in the severity of the incidents.
Of course, over time we realized that being able to report, call for help, and get a response was critical to reducing injuries. I think hospitals still struggle to some extent with implementing effective policies; However, we are seeing more open discussions, policies, protocols and even technologies being put in place to help healthcare workers, including nurses, get help when they need it.
Many organizations have developed an assessment process to identify patients who may be prone to aggressive behavior. The CDC offers such assessments on their website. Identifying these patients, their triggers, environments and diagnoses is critical to keeping patients and workers safe.
Over time, evaluating commonalities could provide insight into what causes aggressive behavior. There is always an opportunity to evaluate the patient experience, including patient wait times, time spent with the physician, time spent in exam rooms, and time spent waiting for the physician to arrive.
Poor environmental design, poor lighting, inadequate security, long wait times and poor staffing have all been identified as causes of workplace violence. We need to collect this crucial data and work to improve the patient experience throughout the process and reduce tension and the potential for violence in the workplace.
The combination of assessment and intensive evaluation of people and places, based on data, on wait times and patient experiences, helps reduce aggressive actions and outbursts from patients and families.
Q. You claim that technology can help reduce workplace violence against nurses. Let’s start with Internet of Things devices, which you refer to. What role do they play?
A. Robust teams, including security, leadership, and frontline staff, can create policies, conduct training, and engage all workplace and community entities. However, the ability to call for help when needed requires a technological solution.
Most hospitals provide an emergency call light or number, but the person under duress must be able to reach this from anywhere. We regularly see duress buttons placed on the side of another piece of technology, mounted on a wall in the patient room, or placed in some other awkward way. This is not enough.
And it has proven time and time again that it does not protect healthcare workers prevent incidents of workplace violence. To ensure that the nurse can immediately call for help, the call device must be worn.
More and more hospitals are using portable emergency call devices to locate the user wherever they are at the touch of a button. The user does not have to call, text or otherwise call for help. With just the push of a discreet button, help is on the way.
Wearable Duress Buttons with Instant Alerts: The technology is here and now and has proven to be successful with the following features and capabilities:
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Lightweight and comfortable
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Be part of already existing wearables (such as ID badges)
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Can be programmed to summon any entity for immediate response
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Activate a silent alarm including a haptic response for the nurse
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Accurate location determination down to room level
And most importantly, portable duress alarms must be consistently reliable and reliable. I cannot emphasize this enough. For any security solution, it is critical that you work with partners who have a proven track record of success and reliability.
Q. And one more technology: artificial intelligence. What role does AI play?
A. AI plays a major role in the orchestration of healthcare. The data provided by inpatient journey analytics (powered by real-time in-home location data), including workplace violence technology, helps optimize processes and resources by revealing how patients and staff move through the healthcare system to move.
AI in combination with IoT and RTLS can help healthcare organizations protect their workforce, optimize workflows and save money. This is the future of healthcare activities.
AI-powered analytics can ultimately be used to determine vulnerable areas, the frequency of events and the people involved. AI can provide answers to questions about which areas to focus on for operational or educational improvement opportunities.
AI can combine patient assessments with technology reports to identify patients at high risk for violent events and proactively identify an at-risk patient for the care team. Having the data is the foundation for facilitating machine learning of the environment, workflows and solutions.
Using the same technology for other use cases, such as asset tracking and management, patient discharge, etc., makes the data more robust and the intelligence more insightful and actionable.
Q. Please describe a real-world example of these technologies in action and the results they have achieved.
A. Northeast Georgia Health System sought a new system that would improve staff safety. Hospital leaders noted that patients, especially with emergency room visits, not only have to deal with their medical conditions, but also bring with them their fears, vulnerabilities, socioeconomic issues and family issues.
As a result, frontline workers sometimes felt unsafe interacting with patients and their families.
To improve staff safety, NGHS has equipped 9,000 staff members with portable duress buttons that are location-aware and integrated into existing security and nursing workflows. When employees find themselves in what they think is a dangerous situation, they can simply click a button to alert security teams that they need help.
Since the introduction of wearable duress buttons, hospital leaders report that staff feel safer and appreciate the extra layer of protection.
In addition, NGHS uses the same technology to track patients throughout the hospital. This aspect of the platform ensures that NGHS has the right resources in the right place at the right time to deliver high-quality patient care.
For example, when a physician is conducting rounds and a particular patient is not in the room, the technology informs the physician of the patient’s absence, saving time and encouraging greater efficiency in resource allocation.
Hospital leadership reports that employees are eager to wear the discreet technology that allows them to provide help when needed and stop the escalation of workplace violence. This is more than just a safety measure; it is also part of an innovative strategy to optimize healthcare operations, save costs and improve the way care is delivered to patients.
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