Health Care Worker Violent Deaths in the Workplace: A Summary of Cases From the National Violent Death Reporting System

Abstract

Background: Violent workplace deaths among health care workers (HCWs) remain understudied in the extant literature despite the potential for serious long-term implications for staff and patient safety. This descriptive study summarized the number and types of HCWs who experienced violent deaths while at work, including the location in which the fatal injury occurred. Methods: Cases were identified from the Centers for Disease Control and Prevention’s National Violent Death Reporting System between 2003 and 2016. Coded variables included type of HCW injured, type of facility, and location within the facility and perpetrator type among homicides. Frequencies were calculated using Excel. Findings: Among 61 HCW deaths, 32 (52%) were suicides and 21 (34%) were homicides; eight (13%) were of undetermined intent. The occupations of victims included physicians (28%), followed by nurses (21%), administration/support operations (21%), security and support services (16%), and therapists and technicians (13%). Most deaths occurred in hospitals (46%) and nonresidential treatment services (20%). Within facility, locations included offices/clinics (20%) and wards/units (18%). Among homicide perpetrators, both Type II (perpetrator was client/patient/family member) and Type IV (personal relationship to perpetrator) were equally common (33%). Conclusion/ Applications to Practice: Suicide was more common than homicide among HCW fatal injuries. Workplace violence prevention programs may want to consider both types of injuries. Although fatal HCW injuries are rare, planning for all types of violent deaths could help minimize consequences for staff, patients, and visitors.

Homicides of psychologists, physicians, nurses, pharmacists, social workers, and other health professionals: National Violent Death Reporting System data 2003–2020

“…Workplace violence, while often resulting in injury, is usually not fatal (Occupational Safety and Health Administration, 2016). Nevertheless, healthcare workers can become victims of homicide both related to their work in healthcare (Braun et al, 2021) and outside of their work (Palmer et al, 2023; Robiner & Li, 2022; Robiner & Dorzinski, 2023). The epidemiology of health professionals' homicides has garnered limited attention (Goodman, 1994).…”

Educational programs and interventions for health care staff to prevent and manage aggressive behaviors in acute hospitals: a systematic review

“…Although it is suggested that nurses have greater exposure to occupational violence and aggression, estimates are influenced by time spent with patients, differences in reporting, and contextual and sociological factors 3 . Alarmingly, several studies have reported health care staff being killed while on duty as a result of workplace violence 2,6,7 . Factors purported to influence violence against health care workers include context of practice, setting, or discipline 3 .…”

Suicide and homicide deaths of PAs

“…9 Consistent with patterns of violent death in the general population, healthcare workers are more likely to die by suicide than homicide. 15 A systematic review revealed that physicians are at risk for death by suicide and emphasized the need to implement studies investigating death by suicide in other healthcare professionals. 16 The rate of homicides of healthcare professionals also is alarming.…”

“…The incidence of healthcare professionals who die by suicide has been estimated by some researchers to exceed rates in the general population 9. Consistent with patterns of violent death in the general population, healthcare workers are more likely to die by suicide than homicide 15. A systematic review revealed that physicians are at risk for death by suicide and emphasized the need to implement studies investigating death by suicide in other healthcare professionals 16…”