Reduce Workplace Violence with Nursing-Focused Tech


It’s no secret that working in healthcare can be hazardous to your health, especially for nurses. A 2022 National Nurses United survey of hospital-based respondents found a 57% increase in workplace violence from the previous year.

Workplace violence in healthcare has been a serious concern for years, but it has increased since the COVID-19 pandemic. Already stressed-out family members and patients grew even more upset at COVID-era requirements such as visitation restrictions.

“It predisposed us to more emotional reactions by family members, and maybe even patients themselves, because they were among strangers,” says Sharon Pappas, PhD, RN, NEA-BC, FAAN, chief nurse executive at Emory Healthcare in Atlanta, who co-chaired the American Organization for Nursing Leadership committee on evidence-based approaches to reducing workplace violence in 2014.

But technology can help cut down on these incidents, says Bonnie Clipper, DNP, MA, MBA, RN, CENP, FACHE, FAAN, founder and CEO of Innovation Advantage, a healthcare innovation consultancy specializing in virtual nursing care delivery models.

Two-thirds of U.S. chief nursing officers are already interested in, researching, or rolling out a virtual nursing care model, she says. These solutions can also increase workplace safety through wiring patient rooms with cameras, speakers, microphones, and more to provide increased attention for possible threats.

In addition to wired rooms and badge alert buttons, artificial intelligence (AI) could provide a potential answer down the road. AI solutions are still in the works but could predict and preempt behavioral risks, while virtual reality can provide more realistic de-escalation training. And seamless incident reporting could help incentivize uptake and provide insights on prevention strategies.

Clipper recommends not just grabbing the latest shiny new innovation before looking at the bigger picture of what you need. She asks her virtual nursing clients to consider the following:

  • What’s the real problem you’re trying to solve?
  • What will the model look like in your organization?
  • What are the specific use cases?

When you’re designing this strategy, take an interdisciplinary approach that includes nurses, security personnel, and AI and data experts. Pappas said Emory put together a group to look at workplace safety performance and implement ways to facilitate daily discussion on incidents and opportunities to improve.

“That’s how you learn, and that’s how you get better and get safer,” she adds.

Emory named two co-chairs, a chief nurse and an operations leader, who added a behavioral health expert to help with the effort. “This isn’t something that you do top down,” Pappas says. “We wanted to get people as connected and oriented toward the first line of workers as we possibly could.”

Once you have your strategy in place, you can look at specific tech solutions. AI can help during the intake process to identify factors (e.g., diseases, conditions, family dynamics) that could make patients more likely to act out violently, says Clipper. 

“If we have ways to identify, predict, and prevent, that’s way easier for us to deal with than the more subjective, moral, and value-based conversations,” she adds. “Do you press charges? Do you issue a criminal trespass warrant?”

Tech solutions can also help improve training on recognizing and responding to violence in your facility. Virtual reality applications can produce realistic simulations to help improve skills such as de-escalation and crisis prevention, Clipper notes.

Last year, UT Southwestern Medical Center and UT Dallas designed a VR training tool that puts clinicians in a virtual hospital exam room and presents a series of patient encounters to let them practice de-escalation tactics. Using VR this way is becoming a popular way to help caregivers improve their skills in these situations.

“When you go through those scenarios, you get to test over and over again what you should do, what you should say, how that works,” Clipper says.

Incident reporting is a crucial way to understand workplace violence better and develop strategies to improve safety, Pappas says. Emory has integrated reporting with its EHR to automate the process as much as possible, and as a result, has seen improved reporting  across the board.

“We were able to detect, by operating unit, that we were having increases at just about every site in the amount of reporting they do,” says Pappas.

Emory has implemented a five-tiered huddle system from the frontlines to operating unit leadership that takes the reporting information and acts on findings.

Pappas says sometimes low-tech solutions can be the answer, depending on the situation. It’s important to determine when and when not to add shiny new technologies.

For more information, see PSQH’s National Nurses Week Special Report, co-sponsored by Collette Health.