• Workplace Violence Response & Staff Support Model. Prevent, Respond, and Report. 

About one year ago a nurse at our hospital was attacked by a patient. This assault resulted in surgery for a fractured mandible.  While this should be a never event, violence against healthcare workers is an all too common reality. Healthcare workers are at four times the national average for serious workplace violence (Bureau of Labor Statists 2013).  The American Nurses Association reported in 2014 a 21% physical assault rate and 50% verbal abuse rate over a one year period.  An Emergency Nursing Association Survey reported 12% physical violence and 42% verbal abuse for nurses during a one week study period.  Both surveys note that few of the nurses ever report the crime. One part of our response to this critical event was a decision that we need an alert in the electronic medical record to clearly and early identify a patient who has violent behavior at our hospital.  We used the FYI functionality to alert clinicians of a patient in the hospital with a history of violent conduct. An FYI flag is placed in the header, a related orange “V” is placed in the header, columns in system lists were made and report banners are used.  When triggered, the FYI flag gives a timely clinically focused plan how best to handle each individual.  

Publication Date: 
2017
Hospital: 
Stanford Health Care
Toolkit Category: 
Arrival
Bed Placement
Clinician Initial Evaluation
Disposition Decision
Exit from ED
Clinical Areas Affected: 
Ancillary Departments
Emergency Department
Emergency Medical Services
Environmental Services
Inpatient Units
Psychiatric Consult Departments
Registration
Triage
Staff Involved: 
Administrators
Ancillary Departments
Case Management
Charge Nurses
Clerks
Clinic Registration
Communications
Consult Services
ED Staff
Inpatient Medical Staff
IT Staff
Nurses
Physicians
Registration Staff
Social Workers/Case Managers
Technicians