Workplace violence remains a significant and increasing challenge for healthcare organizations. Violence can come from patients, visitors, or team members, and is often linked to underlying conditions such as delirium or dementia. These diagnoses increase risk due to confusion and agitation, which can escalate to injury (Black et al., 2025). The American Nurses Association urges organizations to implement comprehensive prevention programs, including safety committees, data analysis, engineering controls, and ongoing training (ANA, 2025).
Kaiser Permanente Santa Clara (KP SCL) prioritizes workforce safety through a multifaceted strategy led by Paul Simpson, CHPA, one of only 396 professionals worldwide with the Certified Healthcare Protection Administrator credential. KP SCL’s Prevention of Workplace Violence Plan outlines reporting, investigation, training, and environmental assessments. Simpson provides annual Vistelar training focused on de-escalation and APPIH sessions for patient-initiated harm prevention.
Department 135 Telemetry, a 26-bed unit caring for post-stroke patients, faced an increase in RN injuries. Up to half of stroke patients experience delirium, which can trigger aggression (Gjestad et al., 2025). In response, Charge Nurse Suki Dhillon, DNP, RN, PCCN, and Clinical Nurse Aidan Broussard, BSN, RN, TCRN, SCRN investigated assaults and found delirium as a key factor and launched a quality improvement project to reduce RN assaults.
Green blankets and lightning bolt magnets serve as visual cues for patients at risk of agitation and were introduced with renewed emphasis. Department 135 Nurse Manager John Olague, MSN, RN, partnered with Simpson to provide on-unit education, stressing consistent use of these cues and proactive security engagement. Supplies were stocked to ensure adoption. Simpson reinforced strategies during huddles, advising nurses to call security before entering rooms of agitated patients. These measures align with American Nurses Association recommendations for prevention programs and security presence.
Following targeted education and visual cue implementation, RN assault rates in Department 135 Telemetry declined, demonstrating the impact of proactive safety strategies.
References
American Nurses Association. (2025). Incivility, bullying, and workplace violence: ANA position statement. https://www.nursingworld.org/globalassets/practiceandpolicy/nursing-excellence/incivility-bullying-and-workplace-violence–ana-position-statement.pdf
Black, C., Sobel, N., & Williams, J. (2025). Keeping Clinically-Rooted Interventions at the Heart of Hospital Workplace Safety. The American Journal of Geriatric Psychiatry, 33(1), 15-17.
Gjestad, E., Nerdal, V., Saltvedt, I., Lydersen, S., Kliem, E., Ryum, T., & Grambaite, R. (2024). Delirium in acute stroke is associated with increased cognitive and psychiatric symptoms over time: The Nor-COAST study. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 33(6), 107667. https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.107667