Pitfalls and Platforms in Workplace Violence Prevention.

Objective: To identify common pitfalls of workplace violence (WPV) prevention programs, as well as platforms for effective WPV prevention and management. This discussion paper elaborates on these pitfalls and platforms, sharing ideas on how to maintain safety and provide support for both colleagues and patients.

Methods: The American Psychiatric Nurses Association (APNA) Council for Safe Environment (CSE) members met monthly to discuss WPV prevention, guided by evidence-based information, clinical expertise, and scholarly work. Concepts around WPV prevention were organized into common pitfalls in WPV prevention programs and optimum WPV prevention platforms. Pitfalls include reliance on attempts to control patients through strict rules, restrictions, and risk identification and monitoring. Alternatively, effective platforms include engagement-focused, relationship-based, trauma-informed and recovery-oriented practices. Education to develop staff skills and expertise beyond crisis prevention training and violence assessment is highlighted, giving voice to nurses' intuitive expertise in preventing, identifying, and diverting aggressive behaviors. Peer and organizational support interventions for nurse victims of violence are also examined.

Results: Safe environments are enhanced when staff are actively engaged in efforts to discern and meet individual needs, engage with the patient, build trust, and communicate hope for recovery. Organizational cultures founded on concepts of trauma-informed care can provide the support victims of violence need to recover and develop resilience and post-traumatic strength.

Conclusion: Risk management strategies alone are ineffective means of preventing WPV in psychiatric settings. Organizations must strike a balance between ensuring safety and providing a therapeutic atmosphere.