Nurses are one of your healthcare facility’s most valuable assets. They are also the most likely to be the victims of workplace violence. Have you implemented the right measures to ensure their safety as part of your efforts to retain them?

According to Bureau of Labor Statistics, registered nurses were the victims of 46% of all non-fatal assaults and violent acts that resulted in days away from work. If your facility is like most, your nursing staff is already stretched thin due to staff shortages and budget restrictions resulting in increased workloads and creating an even more stressful atmosphere in an already high-stress, faced-paced workplace for both your staff and your patients and significantly increasing the likelihood of a violent incident. The devastating effects caused by a physical attack or even verbal abuse upon a member of your healthcare staff can have reverberating and lasting impacts on your employees and hospital operations.

What are the tangible and intangible costs associated with workplace violence against nurses and other hospital staff members?

  • Injured staff member’s lost work time and healthcare expenses
  • Reduced employee morale
  • Attrition – losing staff to other departments, other hospitals or having them leave the profession entirely
  • Worker’s Compensation Claims and Liability Lawsuits
  • Tarnished hospital reputation for future patients and prospective employees

What are some of the major triggers prompting patients to attack nurses and other staff members?

According to the CDC’s report on Occupational Hazards in Hospitals, there are a number of risk factors present in hospital environments and most particularly in Emergency Departments and Waiting Areas that can trigger violence:

  • Working with volatile people, especially if they are under the influence of drugs or alcohol or have a history of violence or certain psychotic diagnoses
  • Working when understaffed – especially during meal times and visiting hours
  • Transporting patients
  • Long waits for service
  • Overcrowded, uncomfortable waiting rooms
  • Working alone
  • Poor environmental design
  • Inadequate security
  • Lack of staff training and policies for preventing and managing crises with potentially volatile patients
  • Drug and alcohol abuse
  • Access to firearms
  • Unrestricted movement of the public
  • Poorly lit corridors, rooms, parking lots, and other areas

What can your facility do to protect its nurses and other staff members from potential attacks and verbal abuse?

In their November 2011, Emergency Department Violence Survey Study, the Emergency Nursing Association (ENA) reported findings indicating that out of 19 studied Environment Control Measures (ECM), the installation of a panic button / silent alarm was the only ECM shown to lower the odds of physical violence. When combined with other violence prevention measure, a hospital can take a comprehensive approach to best ensure the safety of its nurses and other staff members. As part of their Guidelines for Preventing Workplace Violence for Health Care and Social Workers, OSHA recommended a list of security measures that healthcare facilities can take to help prevent and control of workplace violence and attacks against nurses and staff, including the following:

Environmental Designs

  • Assess any plans for new construction or physical changes to the facility or workplace to eliminate or reduce security hazards.
  • Install and regularly maintain alarm systems and other security devices, panic buttons, hand-held alarms or noise devices, cellular phones and private channel radios where risk is apparent or may be anticipated. Arrange for a reliable response system when an alarm is triggered.
  • Provide metal detectors—installed or hand-held, where appropriate—to detect guns, knives or other weapons, according to the recommendations of security consultants.
  • Use a closed-circuit video recording for high-risk areas on a 24-hour basis. Public safety is a greater concern than privacy in these situations.
  • Establish "time-out" or seclusion areas with high ceilings without grids for patients who "act out" and establish separate rooms for criminal patients.
  • Provide comfortable client or patient waiting rooms designed to minimize stress.
  • Lock doors to staff counseling rooms and treatment rooms to limit access.
  • Provide lockable and secure bathrooms for staff members separate from patient/client and visitor facilities.
  • Lock all unused doors to limit access, in accordance with local fire codes.

How can the Secure Care RTLS solution suite help?


As noted in the Emergency Department Violence Survey Study (November 2011) from the ENA, panic buttons and silent alarms are the only Environmental Control Measure proven to help in reducing violent attacks against nurses and other staff members. Unfortunately, simply installing a static panic button is not enough because nurses, doctors and other staff members who are the victims of violence may not be able to get to a static, wall-mounted button during or after attack. That is why as part of its RTLS solution suite, Secure Care offers a wearable staff badge which includes a panic button to trigger a silent alarm to summon help. The benefits of this type of badge include:


  • Ready access for any staff member under attack
  • Real-time location of staff members in need of assistance
  • Alert escalation capabilities – the system can be configured to find the closest security guard or other staff member with the appropriate de-escalation and violence prevention training and alarms can be escalated when no response is received within a defined period.

Note: Due to the potential for strangling hazards, we recommend that staff badges not be worn on lanyards.

The RTLS customized solution can also include a Patient Flow module as part of your facility’s solution. Patient Flow allows staff to have a real-time inventory of available treatment rooms permitting them to relieve patient wait times in the ER by moving patients more efficiently to clean treatment rooms where they can receive the necessary care and help avoid stressful, long wait times in overcrowded ER rooms and waiting areas.

More Information about ENVisionIT RTLS