FigureWorkplace violence prevention remains a top priority for health care professionals (HCP). The American Nurses Association reports that nearly 1 in 4 nurses are physically assaulted during their careers.1 The World Health Organization estimates that between 8% and 38% of all HCPs suffer from some form of physical violence.2 These are alarming statistics. Notably, these figures are reported as approximate because workplace violence remains significantly underreported. Many HCPs believe that exposure to violence is simply part of the job. This belief is rooted in a long-standing culture of tolerance for unacceptable behaviors. Given extensive evidence regarding workplace violence, both the Centers for Medicare & Medicaid Services3,4 and The Joint Commission now directly address workplace violence prevention within their compliance standards. The evidence is clear: we have a problem, and it requires action. A commonly accepted best practice for prevention is behavioral management programs. For many years, the gold standard has been the Crisis Prevention Institute. Acute care facilities have traditionally required additional competencies for high-risk areas. These programs have increased awareness and encouraged reporting. Simply put: you do better when you know better. Today, there are multiple training programs available, but one area that deserves focused discussion is de-escalation training. De-escalation education is embedded within most behavioral management programs, but there are also specialized offerings. Based on my experience reviewing health care data, organizations that implement de-escalation training across all departments—not just high-risk areas—see a positive impact. De-escalation can and does reduce the volatility of interactions. This education improves an HCP's ability to recognize early warning signs of escalation, both physical and verbal. Individuals who are becoming increasingly irritated often display clear cues such as a clenched jaw, pacing, intense eye contact, exaggerated hand motions, elevated voice tone, and aggressive language choices. Recognizing these signs early allows professionals to adjust their approach, choose effective language, establish boundaries, request assistance when needed, and exit unsafe situations when possible. De-escalation doesn't resolve every situation, but it significantly improves situational awareness and personal safety. Learning how—and when—to set boundaries is a powerful skill that protects both staff and patients. Those with hands-on direct care experience may think that they can't de-escalate and still provide care. That concern is valid. Sometimes interaction with an escalated individual is unavoidable. However, de-escalation training provides better tools for managing even these difficult encounters and reducing the risk of harm. Situational awareness, basic self-defense, and de-escalation skills to prevent violence are essential tools. I encourage everyone to review the American Nurses Association's resources on workplace violence and de-escalation and continue to seek education on programs and strategies to improve safety—not only in the workplace, but beyond it as well.
A Wed, study studied this question.