OSHA Guidelines for Preventing Workplace Violence in Healthcare

Home healthcare nurse with patient

Healthcare and social service professionals play an essential role in providing critical care and support to our communities. Unfortunately, they are also exposed to significant workplace violence risks, which can negatively impact their well-being and affect the quality of care they provide. In 2013, over one-quarter of fatalities in healthcare and social service settings resulted from assaults and violent acts, highlighting the pressing need for effective guidelines to address this issue. A recent report from WorkplaceBC revealed workplace claims related to violence increased 25 percent in the past five years with the vast majority of claims related to the health care and social services.  

This article will examine the unique challenges faced by healthcare and social service workers and explores the Occupational Safety and Health Administration (OSHA) guidelines for preventing workplace violence. We will discuss how implementing these guidelines is crucial for the safety and well-being of employees and the communities they serve. Additionally, we will explore the potential impact of new legislation introduced to prevent workplace violence and offer proactive steps healthcare and social service organizations can take to prepare for the changes ahead. 

Challenges Faced by Healthcare and Social Service Workers 

Data from the Bureau of Labor Statistics (BLS) and the National Crime Victimization Survey (NCVS) reveal that healthcare and social service settings experience a higher number of work-related assault injuries necessitating time off compared to other sectors. Between 2011 and 2013, annual workplace assaults ranged from 23,540 to 25,630, with 70-74% of these incidents occurring in healthcare and social service sectors. Research also suggests that workplace violence is underreported, indicating that actual rates may be even higher; especially since the pandemic.  

Healthcare and social service workers face heightened risks of work-related assaults due to factors such as patients, clients, or residents exhibiting violent behavior, and working in high-risk settings such as inpatient and acute psychiatric services, geriatric long-term care, high volume urban emergency departments, and residential and day social services. Other individual risk factors include working with people with a history of violence, drug or alcohol abuse, gang members, or patients' relatives, as well as inadequate workplace design, lack of emergency communication, weapon prevalence among patients and their families, and high-crime neighborhoods. 

Organizational risk factors encompass the absence of policies and staff training for recognizing and managing hostile behavior, understaffing, high worker turnover, inadequate security and mental health personnel, long wait times and overcrowded waiting rooms, unrestricted public movement in clinics and hospitals, and a perception that violence is tolerated, and reporting incidents is discouraged. 

OSHA Guidelines for Preventing Workplace Violence 

The Occupational Safety and Health Administration (OSHA) is a U.S. government agency responsible for ensuring safe and healthy working conditions for employees. OSHA has developed guidelines  to assist healthcare and social service workers in preventing workplace violence. These guidelines aim to protect workers from physical assaults, threats, harassment, and other acts that can result in injury or emotional harm. The guidelines include the following recommendations: 

Management Commitment and Employee Involvement: Establish a comprehensive, written program that involves employee input and clearly outlines workplace violence prevention policies and procedures. 

Worksite Analysis: Conduct regular assessments to identify hazards, risks, and potential areas for workplace violence. 

Hazard Prevention and Control: Implement measures to prevent and control identified hazards, such as installing security systems, improving lighting, providing personal alarm devices to employees, and restricting access to certain areas of the facility. 

Training and Education: Provide training and education programs for employees to help them recognize potential risks and respond appropriately to workplace violence incidents. 

Record keeping and Evaluation: Maintain records of workplace violence incidents and regularly evaluate the effectiveness of the prevention program. 

Post-Incident Response: Have a plan in place to respond to workplace violence incidents, including providing medical care and support to victims, conducting investigations, and reviewing and updating prevention measures as necessary. 

The Importance of Implementing OSHA Guidelines 

Adhering to OSHA guidelines for preventing workplace violence is crucial for healthcare facilities and social service organizations due to the unique challenges and risks faced by workers in these sectors. 

In addition to promoting a safe and healthy work environment, implementing these guidelines benefits the organizations and the communities they serve in various ways: 

Protecting Vulnerable Populations: Healthcare and social service workers often interact with individuals experiencing distress, mental health issues, or substance abuse problems, which may increase the likelihood of violent incidents. Implementing OSHA guidelines helps protect workers in these situations and fosters a safer environment for patients and clients. 

Reducing Stress in High-Stress Environments: Healthcare and social service settings can be high-stress environments, with workers exposed to emotionally charged situations and potential burnout. By implementing workplace violence prevention measures, organizations can reduce stress levels and promote employee well-being. 

Enhancing Employee Retention and Satisfaction: Ensuring employee safety can lead to higher job satisfaction and increased retention rates. By prioritizing workplace violence prevention, organizations can attract and retain highly-skilled professionals, resulting in better service delivery and improved patient outcomes. 

Mitigating Legal and Financial Implications: Implementing OSHA guidelines can help organizations avoid potential legal and financial consequences resulting from workplace violence incidents. This includes workers' compensation claims, lawsuits, and damage to the organization's reputation. 

Ensuring Regulatory Compliance: Healthcare facilities and social service organizations may be subject to federal, state, or local regulations regarding workplace safety. Implementing OSHA guidelines can help ensure compliance with these regulations, reducing the risk of fines or other penalties. 

Building Community Trust: By proactively addressing workplace violence and prioritizing employee safety, organizations can build trust with the communities they serve. This trust can lead to increased engagement, support, and utilization of services provided by the organizations. 

Preparing for HR 1195 

 HR 1195, also known as the "Workplace Violence Prevention for Health Care and Social Service Workers Act," is a bill proposed in the US House of Representatives to require the Occupational Safety and Health Administration (OSHA) to establish a standard for healthcare and social service employers to prevent workplace violence. The goal is to protect healthcare and social service workers from violence they may encounter in their workplace. If passed, healthcare organizations will have less than a year to develop and implement a comprehensive workplace violence plan that meets OSHA's standards. 

To prepare for HR 1195, healthcare and social service organizations can take proactive measures to prevent workplace violence. They can begin by assessing their current policies and procedures to ensure alignment with OSHA's guidelines, including adequate training programs, reporting procedures, and incident response plans. Any gaps identified can be addressed by revising policies and procedures. 

Organizations can also conduct a thorough assessment of their workplace to identify potential risk factors for violence, review past incidents, analyze the physical layout of the workplace, and assess the potential for conflicts between workers and patients or clients. Based on this assessment, organizations can take steps to mitigate these risks by implementing security measures, modifying the physical layout, or adjusting staffing levels. 

Training employees is another important step. This training can include instruction on de-escalation techniques, self-defense strategies, and recognizing warning signs of violent behavior. Providing comprehensive training empowers employees to take proactive steps to prevent violence and respond appropriately if an incident occurs. 

Lastly, organizations should stay informed about HR 1195 and any new requirements introduced. By being prepared to comply with new standards or requirements, organizations can ensure the safety of their workers and comply with the new legislation. 


 To summarize, workplace violence is a major issue for healthcare and social service workers, with a higher number of work-related assault injuries in these sectors compared to others. OSHA has developed guidelines to assist healthcare and social service workers in preventing workplace violence, which include management commitment, employee involvement, worksite analysis, hazard prevention and control, training and education, recordkeeping and evaluation, and post-incident response. Implementing these guidelines not only promotes a safe and healthy work environment but also protects vulnerable populations, reduces stress in high-stress environments, enhances employee retention and satisfaction, mitigates legal and financial implications, ensures regulatory compliance, and builds community trust. 

Moreover, HR 1195 is a bill introduced to mandate OSHA to establish a standard for healthcare and social service employers to create and implement comprehensive plans to prevent workplace violence. Healthcare facilities and social service organizations can prepare for HR 1195 by reviewing their current policies and procedures, conducting a thorough assessment of their workplace, prioritizing training for their employees, and ensuring they are prepared to comply with any new requirements that may be imposed by HR 1195. 

In conclusion, it is vital for healthcare and social service organizations to prioritize workplace violence prevention measures to ensure the safety and well-being of their workers and promote the overall success and sustainability of their organizations and communities they serve.