Recommendations

Violence in the workplace is taking a significant toll on the nursing profession.  Violence, both physical and psychological, has had a negative impact on nurses’ attitudes toward the nursing profession, and recruitment and retention efforts.  To address these challenges, the NACNEP is putting forward a set of recommendations in the following four areas: regulatory; educational programs; nursing practice interventions; and data collection and dissemination.  Through the following recommendations, the NACNEP believes progress can be made in addressing these challenges facing the profession. 

Regulatory

• Develop and adopt a standard definition of workplace violence; strengthen and adopt regulatory and/or accrediting agency (e.g., Occupational Safety and Health Administration) recommendations on workplace violence in health care settings including institutional, community, and academic settings, as a requirement for workplace safety.

Educational Programs

• Target faculty development initiatives on violence in nursing focusing on prevention, early intervention, legal and ethical issues, and access to resources and referral systems in both educational and clinical environments.
• Target funding to support basic and continuing education initiatives focused on evidence-based core competencies (knowledge, attitudes, skills, and behaviors) related to workplace violence and violent behaviors.
• Improve basic and continuing education programs for nursing personnel including faculty, staff, and students, on self-protection in violent situations and competency in violence prevention and management.

Nursing Practice Interventions

Transition the health care culture into one in which a secure work environment for nurses and other health care workers is a priority:

• Establish clear standards for workplace safety supported by resources for the management of violence.
• Eliminate institutional barriers for a safe work environment by supporting a culture of open communication and reporting among nursing staff, faculty, health care personnel, and students regarding violence in the workplace.
• Offer violence prevention and management training in the workplace.
• Keep violence and security issues on the radar screen of risk managers in health care facilities. 
• Provide clearly defined support resources such as legal and psychological services, to nurses in violent situations, or at risk of facing violent situations.
• Include violence prevention and management in the criteria for the American Nurses Credentialing Center Magnet Recognition Program.
• Support demonstration projects for implementation of best practice models in violence prevention and management in health care settings.
• Disseminate information on model violence prevention programs and best practices including programs appropriate for smaller/rural health care facilities.
• Disseminate information on available resources and best-practices for violence prevention and management protocols in health care settings.
• Develop guidelines for conducting employee and student background checks on violent behavior.

Data Collection and Dissemination

• Collate and analyze data on workplace violence from government agencies (e.g., Centers for Disease Control and Prevention, Occupational Safety and Health Administration, the Department of Justice), health care facilities, community-based settings, and in nursing education to:
  • Assess the scope and incidence of workplace violence in Federally funded agencies and track the changes in rates of violence due to policy and procedure interventions;
  • Assess the impact of workplace violence on nurse recruitment and retention;
  • Assess management, documentation, and response to violence in the workplace; and
  • Disseminate information to health care settings in support of increased violence prevention and management programs.
• Incorporate into the 2008 National Sample Survey of Registered Nurses questions on violence in the workplace including the types of violence experienced, formal documentation of violence, and the effect of violence on job satisfaction and retention.
• Provide resources for research on violence against nurses to determine effective prevention, intervention, and management strategies.