Workplace Violence Against Nurses: Use of Patient Screening for Early Identification of Violence

Background: Workplace violence (WV) is a significant problem in healthcare that affects the nurses' physical and mental health and impacts patient care. This is costing healthcare organizations millions of dollars for damage control as there is a lack of prevention. Hence, this evidence-based practice project uses the theory of planned behavior and nursing process discipline theory to explore the effectiveness of screening patients for violence. Method: After an aggregate IRB approval, a violence screening tool with high sensitivity and specificity, Broset Violence Checklist (BVC), was implemented twice daily and as needed for 15 days with 275 adult patients in a neurology/telemetry unit to help identify patients at high-risk for violence. All interventions and procedures were based on established policies, not the BVC score. Results: A generalized estimating approach with a logit link and linear regression was used for data analysis. Of the 1504 BVC screenings completed, 43 violent incidents were reported, with interventions recorded in 106 (7.1%) screenings. Patients with a BVC score of <2 required an intervention 16 times (1.2%), and BVC score of >2 required an intervention 90 times (54.2%), OR= 17.95 (95% CI: 3.55 to 90.84), p< 0.001. Discussions: Total BVC score, male gender, and older age were highly predictive of violence. Also, as the BVC score increased above 1, additional interventions were utilized. Conclusion: The BVC has value, indicating that patients who score above 1 can pose enough threat to require an intervention. Thus, uncovering risks and identifying the potential for violence is essential to diminishing harm and WV.