Facilities with full program implementation noted a modest decline in assault rates (Hodgson et al. 2011; Arnetz, 2000; Runyon et al., 2000; Wassell, 2009).

Given the constraints of conducting organizational intervention research, it is not surprising that so few well-controlled intervention studies exist.

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A comparison of pre- and post-intervention survey data found an improvement in perceived violence climate factors, such as management commitment to violence prevention and employee engagement, but no overall change in assault rates (Lipscomb, 2006).

This study, as well as later studies, found that employees’ perception of management commitment to violence prevention was associated with less workplace violence. In 2005, the Bureau of Labor Statistics (BLS) conducted a national survey of a representative sample of all U. employers (including health care, but not exclusively health care) that assessed both workplace violence experiences and preventive strategies employed to prevent violence.

(CDC/NIOSH, 2006; Lipscomb, London, & Mc Phaul, 2007).

Workplace violence program elements for health care and social services establishments as outlined by OSHA are considered Much like the nursing process for planning nursing care, basic program elements for workplace violence prevention are derived from the standard occupational safety program paradigm and include: 1) management commitment and employee involvement; 2) hazard analysis or assessment; 3) hazard controls; 4) employee training; and 5) recordkeeping and evaluation (OSHA, 2004).

The framework presented is consistent with the Guidelines for Prevention of Workplace Violence in Health and Social Services, a United States (U.

S.) Occupational Safety and Health Administration (OSHA) guidance document (OSHA, 2004).

Addressing violence in health care requires very purposeful organizational processes conducted by very specific organizational structures.

The strength of the scientific evidence for workplace violence prevention strategies is well past the “emerging” evidence stage but has not achieved the “unequivocal” stage.

...several states have legislation requiring comprehensive workplace violence prevention programs in health care...