Survey of workplace violence prevention programs in nursing homes

Nursing care facilities are more than seven times as likely to have a worker injured by workplace violence requiring days away from work compared to the overall rate in the private sector (BLS, 2018b). Several states have implemented regulations requiring workplace violence prevention programs in healthcare facilities, including nursing homes.

The manager responsible for workplace violence prevention programs at twenty long-term care (LTC) facilities in New Jersey (n=9) and Virginia (n=11) voluntarily participated in a face-to-face interview utilizing a validated survey regarding workplace violence programs in their facilities. This project compared the comprehensiveness of nursing home workplace violence prevention programs in New Jersey (NJ) where the "Workplace Violence Prevention in Healthcare Facilities Act" was enacted with the comprehensiveness of programs in Virginia (VA) where no workplace violence regulations exist.

Descriptive statistics show that there was variation in workplace violence prevention program components, such as training, reporting, and risk assessments, where some facilities had relatively comprehensive programs and others had weak programs. Virginia, the control state without any workplace violence regulations generally had equal implementation compared to the New Jersey, the regulated state. Overall nursing home characteristics and its relationship to security program implementation was mixed. LTC facilities with above average Centers for Medicare and Medicaid Services (CMS) ratings and non-profit status reported higher utilization of environmental controls. The data shows that facilities in Virginia (non-regulated state), non-profit facilities, corporate owned, and facilities with high CMS ratings tended to have a high level of training. It was also found that corporate owned facilities had more extensive implementation of security programs.

This survey demonstrated that nursing home administrators are aware of workplace violence in their facilities and have instituted programs and policies to attempt to address this issue. However, these programs and policies are diffuse and "ad-hoc" in nature, likely making them less effective. A lack of regulatory enforcement and the lack of awareness of regulations contributes to the ineffectiveness of the regulation and implementation of security program elements. Other parameters such as overall nursing home quality (e.g. CMS rating) and corporate versus independent ownership also seemed to impact the comprehensiveness of security programs, but this relationship is multifactorial and less clearly articulated by this study design.