Workplace violence training for nurses.
Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R43-OH-009180, 2008 Dec; :1-60
Background: Research has shown that nurses are at very high risk of being victims of workplace violence from patients as well as coworkers. For hospitals, consequences of workplace violence against nurses can lead to deterioration in the quality of care to patients, increased errors, worsened patient outcomes, lower patient satisfaction, and have negative effects on recruitment. Results from a 2001 survey of registered nurses by the American Nurses Association revealed that health and safety concerns played a major role in nurses' decisions about leaving the profession - 25% of the nurses surveyed reported a fear of sustaining work-related assault. The American Association of Colleges of Nursing issued a Position Paper in 1999 emphasizing the inclusion of violence-related content as essential content in nursing curricula, yet training remains incidental. The American Nurses Association, the International Council of Nurses and the American Academy of Nursing, as well as health care labor unions, have called for increased research to identify effective interventions. Proposed Intervention: Vida Health Communications, Inc. plans to develop and evaluate Workplace Violence Training for Nurses, a two-part multi-media training package for professional (registered) nurses working in a hospital setting. It will include a self-paced web-based learning program to help nurses understand, assess, prevent, and respond to violence in the workplace. The curriculum will make extensive use of video and multimedia to share expert opinions, victims' experiences and to provide visual case studies to demonstrate effective strategies for assessment, prevention and response, thus allowing for behavior modeling. The program will be divided into five stand-alone modules covering various aspects of nursing workplace violence. Self-administered tests for each module will help to track acquisition of essential knowledge, attitudes, and skills. Continuing education credits will be awarded to program graduates. A separate Workshop Leader's Toolkit will help hospital-based nurse educators conduct workshops (e.g., in-service training) on workplace violence. This Phase I research study developed and tested with focus groups a curriculum and a prototype of the proposed web-based learning program. Key Findings: 1. There is a significant divide between how front-line nurses and workplace violence policy experts perceive the issue. Experts see policy at the core of solutions to workplace violence. Nurses ask how policy can be effective without buy-in from those who the policy affects. 2. Nurses fear being blamed for acts of violence even when they themselves are the victims. Nurses distrust management's motivations for policy implementation fearing that a failure to closely adhere to policy will create opportunities for nurse blaming. Nurses also feel that patients' rights often supersede nurses' rights and that this can have a detrimental impact on workplace safety. 3. Lateral violence between co-workers, including bullying and verbal abuse, was a paramount concern to all nurses. 4. There was agreement that the prototype predicts an excellent training for a wide variety of nurse audiences in settings ranging from nursing schools to in-service continuing education offerings. 5. All participants liked the use of the dramatic enactments to illustrate case studies. Application to the Workplace: The results of this Phase I research suggest that there is a significant need for better communication and understanding between institutional administrators and front-line nursing staff. For workplace violence policies to be effective, nurses must feel that they are participants in authoring the policies that affect them. Education of nurses around workplace violence issues, violence prevention, policy making and advocacy strategies will help to engage and empower nurses to work within their institutions to effect policies that they can buy in to.
Education; Training; Nurses; Nursing; Health-care-personnel; Violence-prevention
Lisa A. McElaney, MFA, President, Vida Health Communications, Inc., 6 Bigelow St. Cambridge, MA 02139 USA
Final Grant Report
NTIS Accession No.
National Institute for Occupational Safety and Health
Vida Health Communications, Inc.