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Online Training Helps Protect Nurses and Other Healthcare Workers from Workplace Violence

November 2014
DHHS (NIOSH) Publication Number 2015-118

A Story of Impact :

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Healthcare professionals can complete the Workplace Violence Prevention for Nurses course on any device with an Internet connection. Photo by Thinkstock.

Healthcare workers dedicate their lives to the treatment and care of patients. They sometimes put their own safety and health at risk to help a patient or visitor. The unique culture and unpredictability of hospitals increase the risk of both physical and non-physical violence among healthcare workers. In 2013, there were 9,200 nonfatal workplace violence injuries among healthcare workers, which was more than 67% of nonfatal violence-related injuries occurring in all industries.1 These figures underestimate the burden of workplace violence, because only assaults that resulted in time away from work, and not the psychological trauma or less severe physical injuries that healthcare workers experience from workplace violence, are reported. Additionally, the number of assaults reported by healthcare workers is considered greatly underreported. Some reasons include: lack of awareness, fear of retaliation, unintentional assaults, and persistent perception within the healthcare industry that workplace violence is part of the job, and fear that reporting will reflect poorly on the worker.

Many new and experienced healthcare workers are not formally trained in workplace violence prevention strategies. Recognizing the gap in knowledge, researchers at the National Institute for Occupational Safety and Health (NIOSH) partnered with Vida Health Communications, Inc., to develop an online training course for nurses. This course was developed mainly as a resource for nurses and other healthcare professionals who are required to complete continuing education units to maintain their licenses, but the training can benefit anyone employed in the healthcare industry. From project conception to dissemination, NIOSH researchers collaborated with healthcare workplace violence prevention experts from academia, labor unions, nurse organizations, private consultants, and other government agencies to ensure course content and design met the learning needs of healthcare professionals.


The Workplace Violence Prevention for Nurses online training course incorporates lesson text, videos depicting actual workplace violence incidents, and testimonials from nurses. Healthcare workers can access information regarding workplace violence awareness, risk factors, and prevention strategies through any device with an Internet connection. The course’s “resume-where-you-left -off” technology maximizes flexibility and does not interfere with the caregiver’s ability to quickly respond to a patient should the need arise. Upon completing the 13-unit course, each taking about 15 minutes, nurses and other healthcare professionals can receive free continuing education credits.

Prior to the public release of this course, 204 registered nurses from across the United States completed a course evaluation. The evaluation showed that nurses gained knowledge about workplace violence including how to prevent, assess, and respond to violent incidents. The nurses expressed more positive attitudes about reporting violence in the workplace and confidence that they could intervene to prevent violence. They are also more likely to seek or recommend counseling for those involved in a violent incident. Study participants considered the course to be an excellent learning tool for both new and experienced healthcare professionals.

The online course is being used in various ways by the healthcare community. 6,255 healthcare workers completed the online Workplace Violence Prevention for Nurses course for CEUs from August 2013 thru August 2014.3 Three healthcare facilities have inquired about incorporating the course’s case studies into their lunch-and-learn programs. NIOSH is working with two nursing schools to incorporate the training into their curriculum, and with the West Virginia University School of Nursing to have the course evaluated by nursing students in the clinical stage of their education. This online training can help better protect healthcare workers from workplace violence and it provides valuable tools for preventing, intervening, and reporting these incidents.

Relevant Information
  • About 16.5 million healthcare workers were employed in 2012, making up 11.5% of the total workforce.2 The majority were comprised of nurses and other healthcare professionals that require continuing education units (CEUs) to maintain licensure.
  • Over the past ten years, healthcare workers have accounted for over half of the nonfatal workplace violence injuries involving days away from work across all industries.1

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  1. BLS [2013]. Table R4. Number of nonfatal occupational injuries and illnesses involving days away from work by industry and selected events or exposures leading to injury or illness, private industry, 2013. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics [].
  2. BLS [2013]. Household data annual averages.  Employed persons by detailed industry, sex, race, and Hispanic or Latino ethnicity. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics [].
  3. NIOSH [2014]. Workplace Violence Prevention for Nurses, On-line Course: Continuing Education Units Internal Report. Unpublished data.