Lawmakers seek OSHA standard on workplace violence prevention in health care

Rep. Ro Khanna (D-CA) and 12 other House Democrats have introduced legislation intended to curb workplace violence in health care facilities.

The Health Care Workplace Violence Prevention Act, introduced March 8, would direct OSHA to create a standard that would require health care facilities to develop and implement facility- and unit-specific workplace violence prevention plans.

According to the Bureau of Labor Statistics' Census of Fatal Occupational Injuries, at least 58 hospital workers died as a result of workplace violence between 2011 and 2016. In 2016, the Government Accountability Office found that health care workers at inpatient facilities were five to 12 times more likely to encounter nonfatal workplace violence than all other workers.

The legislation follows regulation enacted in 2014 in California, which went into effect in 2017, directing Cal/OSHA to craft a workplace violence prevention standard. The law requires all covered health care employers in California to develop and issue – by April 1 – plans to prevent workplace violence and ensure the safety of patients and workers.

The bill introduced by Khanna is similar: Workplaces would create and implement comprehensive violence prevention plans with input from doctors, nurses and custodial workers. The bill stresses prevention, training and worker participation. It defines workplace violence broadly to include not only physical acts of violence, but threats of violence. It emphasizes staffing as a crucial ingredient in preventing violence from occurring and responding quickly when it does.

"Health care workers, doctors and nurses are continuously at risk of workplace violence incidents – strangling, punching, kicking and other physical attacks – that can cause severe injury or death," Khanna said in a March 8 press release. "This is simply unacceptable. The Health Care Workplace Violence Prevention Act puts a comprehensive plan in place and is a national solution to this widespread problem modeled after the success seen in California."

National Nurses United, the nation's largest union of registered nurses, applauded the bill.

"Right now, health care facilities are not doing enough to prevent these violent incidents," NNU Co-President Deborah Burger said in a press release. "Under the proposed federal standard, hospitals would need to assess and correct for environmental risk factors, patient specific risk factors, staffing and security system sufficiency. There are a number of interventions that can reduce violence in the hospital.

"For example, affixing furniture and lighting so they can't be used as weapons, maintaining clear lines of sight between workers while they are caring for patients, and providing easy access to panic buttons or phones to call for help. It is imperative that nurses, doctors, and other health care workers, along with security staff and custodial personnel, are all involved in the development and implementation of these plans."