A-zero tolerance:A policy in workplace violence and aggression

Aisha Al Shdefat,Rasha Abu Baker

1Lecturer, Department of Maternal and Child Health, College of Nursing , Sultan Qaboos university, Sultanate of Oman.2Lecturer,Department of Community and Mental Health,College of Nursing,Sultan Qaboos university,Sultanate of Oman.

Aggression and violence in the workplace is an act or threat of violence ranging from verbal abuse to physical assaults against individuals employed or on duty (CDC, 2019).It is considered a global public health issue faced by staff across different sectors,including the healthcare sector.Based on many studies,Oman recorded a high level of workplace violence against nurses among all Gulf Cooperation Council countries [1-3].Al Maskari,et al.(2020) found that throughout Oman, violence in the workplace is highly prevalent among nurses in the emergency department[4].The goal of the current policy is to highlight the value of implementing such a policy.

Workplace violence is defined as any violence,attacks,or threats against employees at work;it may be physical, sexual, and emotional [5].This assault may lead to damage to the person physically and emotionally [6].Worldwide, violence against healthcare workers is increasing across the countries[7].Workplace violence is considered one of the most significant problems in health care setting[8].

Furthermore, public safety, health care, justice employee are more exposed to physical workplace violence [8].A large European study in 25 countries across all Europe, showed that 5% of the employees were exposed to physical workplace violence during the previous 12 months,either by people to whom they provided the service or by fellow employees [9].Occupational Safety and Health Administration (2013)reported that 7.8 out of 10.000 employers in the health care setting are exposed to violence in the united states[10].

Furthermore, the Bureau of Labor Statistics, 2017 data showed that 80 percent of reported violence in the health care setting are caused by interaction with the patient [11].Additionally, 71% out of 18,400 employees exposed to violence were health care and social service professionals [12].Thus, Liu,et al.(2019)revealed that nurses have the highest prevalence of exposure to workplace violence[7].

The high prevalence of workplace violence is troubling and highlights the need for new measures to reduce violence and mitigate its impact on the quality of care of health professionals and patients.Workplace violence affects both nurses and patients.The patient is affected when the nurse who faced violence cannot give him the care he needed and the risk that may cause he suffered because of the violence, while the nurse will be affected emotionally and physically,which will reflect on her job satisfaction.From the institutional side, the health setting will be affected financially because the victim of violence and aggression may need medical care physically and psychologically[13].

A detailed review of published literature identifies one study that examines workplace violence against a health care professional in Oman.Based on The Oman Nursing & Midwifery Council (2011) Code of Professional Conduct acknowledges that providing a safe work environment for nurses is a right and not a privilege 14.Furthermore, The Oman Penal Law(Articles 191-193) protects against abuse in the workplace for public officials, including health care workers [14].Besides, Directorate General of Quality Assurance Center, Ministry of Health (2017) issued recommendations and guidelines for reporting,handling, and preventing workplace violence and aggression in Oman's health care institutions [15].Ministry of Health said “You will be legally accountable following articles of 172 and 173 of Omani penal code for assault, verbally or physically,on employees in health care institutions.”

However, health care professionals continue to see an increasing trend in violent incidents in Oman [16].Establishing a Zero- Tolerance policy is the best step the organization can offer to protect their workers toward workplace violence.The concept of Zero tolerance started in the United States and refers to the action and activity that is not accepted [16].This policy should cover all employees,patients,customers,visitors, contractors, and anyone else who may come into contact with company staff.

The prevalence of workplace violence identified by healthcare workers is troubling and indicates.The need for further efforts to minimize this problem and restrict its impact on health care professionals and the quality of care of patients.Such interventions may include:

1) The organization should provide adequate security for both patients and employee.

2) Employee preparation to identify and handle the initiation of aggressive and threatening actions by patients,customers,guests,or employees.

3) Encourage all workers and other staff to report violent incidents or any suspected threats of violence

4) Develop policy and implementation of workplace violence and aggression program establish a zero-tolerance policy towards violence in all hospitals in Oman.This policy includes the definition of violence, methods of reporting and, responsibility of the employee encourage all employee to activate the policy in all day work.