Workplace Violence and OSHA Regulations

Ever since 2016, the Occupational Safety and Health Administration (OSHA) has publicly questioned whether or not there is a need for a standard to protect healthcare and social assistance workers from workplace violence. OSHA has been conducting inspections and issuing citations related to occupational exposure to workplace violence, but there is still no standard or regulation, nor a law or OSHA standard related to workplace violence.

OSHA’s General Duty Clause

Fortunately, OSHA required all employers to provide their employees a work environment that is “free from recognized hazards that are causing or likely to cause death or serious physical harm” by instituting the General Duty Clause, Section 5(a)(1) of the Occupational Safety and Health Act of 1970. Workplace violence is defined by The National Institute for Occupational Safety and Health (NIOSH) as “violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty.” Some may agree that workplace violence is considered a violation of the General Duty Clause.

Unfortunately, healthcare and social service workers face the highest risk of workplace violence. The World Health Organization (WHO) concluded “between 8% and 38% of health workers suffer physical violence in their careers,” without forgetting to mention that research has found workplace violence to be underreported.

Why are Hospital and Healthcare Settings a Target for Violence?

Hospital settings represent large institutional medical facilities, residential and non-residential treatment facilities, community care centers and field work. The reason these types of settings often encounter job-related violence is because of the risk factors associated with this type of work. Healthcare and social service workers never know who their patient is going to be, or how they are going to act. Not only do these employees work with patients, they encounter patient’s families, other visitors, employees and criminals. So, why are healthcare and social service at a higher risk than any other occupational setting?

  1. Healthcare and social service facilities are generally accessible 24/7.
  2. Patients and their families in these settings may be vulnerable, irritable, or even distraught.
  3. Healthcare and social service workers have to complete tasks under stressful situations.
  4. The presence of drugs makes these settings an attractive target for criminal activity.
  5. The unknown of who will come through the door, what will happen, and how they will react.

OSHA Investigations and Penalties

More recently, OSHA has been investigating the violent incidents that have been reported in healthcare and social service settings. They are even issuing citations to companies who have put their employees at risk. OSHA fined Brookdale University Hospital and Medical Center, a 790-bed hospital in New York, $78,000 because there were dozens of incidents in which patients and visitors assaulted employees. One incident even left a nurse with severe brain injuries.

OSHA is finding that if an employer finds risk of workplace violence, there should be a prevention program implemented to protect their employees from potential harm. If employers are thoroughly performing frequent job hazard analyses, they should be determining violence as a potential hazard to their staff. If there is a potential hazard, it needs to be addressed immediately.

Steps for Developing your Workplace Violence Prevention Program

Since implementing workplace violence prevention programs hasn’t been a mandatory requirement by OSHA, many employers may not have the resources to develop an effective one. Fortunately, OSHA has provided training materials and other resources for creating and implementing an effective workplace violence prevention program, including Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers.

These guidelines highlight 5 important steps in developing a workplace violence and prevention program for any occupation, including:

  1. Management commitment and worker participation.
  2. Worksite analysis and hazard identification.
  3. Hazard prevention and control.
  4. Safety and health training.
  5. Recordkeeping and program evaluation.

As an employer in the healthcare or social service industry, you may ask yourself, “What can I do to make my prevention program effective?”

Step 1: Keep an updated OSHA Form 300.

Step 2: Maintain updated medical reports of work injuries, workers’ compensation reports and supervisors’ reports for each recorded assault.

Step 3: Store an updated record of incidents of abuse, incidents with security personnel, verbal attacks and aggressive behavior that may be threatening.

Step 4: Have information on patients with a history of past violence, drug abuse or criminal activity recorded on patient charts. Flag these patients in a way that makes employees aware and prepared to treat these patients.

Step 5: Conduct frequent “Safety Minutes” meetings. Let this be an opportunity for staff to contribute ideas and express concerns. Keep a record of discussions, and use the meetings to develop policies and procedures that address these ideas and concerns.

Step 6: Perform frequent job hazard analyses. Use findings to develop policies and procedures that address the hazards to prevent injury or harm.

Step 7: Take action from the job hazard analyses. Keep track and record which actions have been taken.

Step 8: Provide training for all employees when they are first hired, and again annually. Keep records of which employees and when they received the training. Make sure the training is provided by a qualified and competent instructor.

The above steps take effort, time and resources. Each step may seem tedious and unnecessary. But, these programs save thousands of healthcare and social services workers from unnecessary physical injury and mental suffering. Not only do these programs keep your employees safe, they keep you, as an employer, compliant.

OccuMed of New England provides Workplace Violence Prevention Training and Program Development services. For more information, please visit our website: