Healthcare employees, such as Registered Nurses, dedicate their careers to the treatment and care of patients, sometimes even risking their own health and safety to help others. Working in a hospital sometimes lends itself to a unique and unpredictable nature. In 2013, more than 67% of nonfatal violence-related injuries across all workplace industries occurred among healthcare workers; and this number only accounts for the reported cases.

 Many assaults towards healthcare workers go under-reported; this may be due to  unawareness, fear that  reporting will result in retaliation or bad reflection on the employee, or the perception that “violence is just a  part of the job.” With this in mind, researchers at the National Institute for Occupational Safety and Health  (NIOSH) recognized the need for formal training regarding workplace violence prevention strategies.  Currently, NIOSH is developing online training resources and modules (which include text, videos, and  testimonials) with the purpose of benefiting a variety of healthcare workers.

One of the developers of these online training courses is Tanner Coles (@MPHTanner), a Master of Public Health student  from West Virginia University (Let’s go Mountaineers!). He kindly agreed to answer a few questions about  the work NIOSH is doing in regards to healthcare workers violence prevention strategies.

1. Can you tell us about yourself and also how you got to working with NIOSH?

My name is Tanner Coles, and I graduated cum laude from Bethany College, located in Bethany, West Virginia, with a degree in chemistry with emphasis in biochemistry. Currently, I am a graduate student at West Virginia University School of Public Health, where I am studying for a Master of Public Health in Occupational and Environmental Health Sciences. I am exceedingly involved within the school community and have a passion for volunteering and helping others, as evident from obtaining the rank of Eagle Scout through the Boy Scouts of America and through my work with the American Red Cross. I became interested in Injury Prevention after taking several graduate courses at WVU entitled Occupational Injury Prevention and Occupational and Environmental Hazard Assessment, which lead me to seeking out this experience at NIOSH, through the assistance of WVU’s Director of Practice-Based Learning. I have a passion for preventing injuries in the workplace and desire to continue working on similar topics within a federal agency upon graduation in December 2015.

2. What is your specific role at NIOSH?

At NIOSH, I work within the Division of Safety Research at the NIOSH office in Morgantown, West Virginia. I serve as a Student Worksite Experience Program (SWEP) Intern, where I am focusing my time assisting in the design of several educational course units including Workplace Bullying and Emergency Department Violence, which are being created to educate healthcare staff on violence and bullying in the workplace, how to go about recognizing warning signs, and how to prevent violence and bullying in the future.

3. Can you tell us about the course education modules that you are working on?

The purpose of these courses is to help healthcare employees better understand the scope and nature of violence in the healthcare workplace. Participants will learn how to recognize the key elements of a comprehensive workplace violence prevention program, how organizational systems impact workplace violence, how to apply individual prevention strategies, and develop skills for preventing and responding to workplace violence. Content is derived from content experts, from the OSHA 2004 Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers (OSHA 3148-01R 2004) and additional research data is used throughout the course that has been taken from peer-reviewed research.

We are in the process of finishing up the Workplace Bullying course and starting the Emergency Department Violence course. These courses are being designed to keep the participants involved throughout the course. After every few slides an interactive question or activity will pop up to ensure participants are understanding the material being presented.

The course units contain sections such as:

1. Background Information & Consequences
2. Risk Factors
3. Prevention Strategies for Organizations
4. Prevention Strategies for Nurses
5. Crisis Management

The courses are intended for the following healthcare professionals who desire an introduction to workplace violence prevention strategies:

– Registered Nurses
– Nurse Practitioners
– Physician Assistants
– Physicians
– Veterinarians
– Health Educators
– Nursing Students
– Medical Students

While the courses are intended for healthcare professionals, anyone in the general public with an interest in the topics can take the courses as well. The courses can be taken for continuing education credits for healthcare professionals at no cost.

4. These courses focus on healthcare staff. Can you give us some background about workplace violence in healthcare settings? Why are these courses important for healthcare staff specifically?

About 16.5 million healthcare workers were employed in 2013, making up 11.4% of the total U.S. workforce. That same year, there were 9,200 nonfatal workplace violence injuries among healthcare workers, which was more than two-thirds of nonfatal violence-related injuries occurring in all industries.

These courses are important for healthcare staff because for the past ten years, healthcare workers have disproportionately accounted for over half of the nonfatal workplace violence injuries involving days away from work across all industries. It is likely, these numbers underestimate the burden of workplace violence, because only assaults that resulted in time away from work, and not the psychological trauma or less severe physical injuries that healthcare workers experience from workplace violence, are reported. Additionally, the number of assaults reported by healthcare workers is considered greatly underreported. Some reasons include: lack of awareness, fear of retaliation, unintentional assaults, fear that reporting will reflect poorly on the worker, and the persistent perception within the healthcare industry that workplace violence is part of the job. These courses aim to prevent these injuries through education and by providing techniques to recognize and prevent violence and bullying in the workplace.

5. When will the courses be made available to the public and where can we find them?

The first course is already available to the public on the CDC/NIOSH website Additional courses and content will be added upon completion and as they are made available.

If you have any questions, please feel free to contact: Dr. Daniel Hartley, Epidemiologist at dhartley@cdc.gov