Workplace Violence Prevention Program Targeting Patients at Risk of Violence in Nonpsychiatric Inpatient Units: A Prospective Interventional Study.

BACKGROUND

Healthcare workers across the world are subjected to increasing workplace violence, mostly arising from patient interactions. Effective workplace violence prevention programs are urgently needed, but there is limited evidence supporting such programs in nonpsychiatric inpatient units.

METHODS

This prospective interventional study evaluated the effectiveness of a workplace violence prevention program. All patients admitted or transferred to four nonpsychiatric inpatient units from November 2024 to August 2025 were included. Following a baseline observational period, Phase 1 interventions were implemented, consisting of screening patients with the six-item Aggressive Behavior Risk Assessment Tool for Hospitalized Patients (ABRAT-H) and posting signage for patients with ABRAT-H scores ≥ 2. During the subsequent Phase 2 period, proactive rounding by a behavioral health response nurse was added to the Phase 1 interventions for patients with ABRAT-H scores ≥ 3.

RESULTS

Of 7,625 evaluable patients, 340 had ≥ 1 violent event (overall rate = 4.46%), while 106 patients committed physical assaults (1.39%). Compared to the baseline observational period, the violent event rate declined significantly during the Phase 2 period (5.30% vs. 3.71%, relative risk [RR] 0.69, 95% confidence interval [CI] 0.53-0.90, p = 0.007). Likewise, the physical assault rate decreased significantly between baseline and Phase 2 (1.89% vs. 0.82%, RR 0.43, 95% CI 0.26-0.73, p = 0.001). However, the decreases in violent events and physical assaults were not statistically significant between baseline and Phase 1.

CONCLUSION

A workplace violence prevention program of screening patients with the ABRAT-H combined with signage posting and proactive nurse rounding for high-risk patients achieved a 31% relative reduction in violent events and a 57% relative reduction in physical assaults.