Addressing Organizational Factors Contributing to the Underreporting of Workplace Violence in Nursing

Background: Nurses routinely face threats, verbal abuse, and physical violence, yet widespread underreporting obscures the full scale of the problem, hindering efforts to address workplace culture and protect nurses. Aim: Through leadership engagement and targeted staff education, this quality improvement project sought to increase workplace violence reporting rates on a 35-bed medical/surgical unit. Methods: Over eight weeks, a three-phase intervention was implemented. Phase one equipped charge nurses with uniquely designed training (DIVER framework) to strengthen leadership support. In phase two, staff received micro-education through established communication channels. Phase three reinforced learning via interactive staff meetings. Pre- and post-intervention surveys assessed changes in perceptions and reporting behaviors. Outcomes: The intervention led to a 19% increase in perceived support from charge nurses, a 7% rise in staff understanding of workplace violence definitions, and 91% of staff expressing a greater likelihood to report incidents. Importantly, the perception of workplace violence as “a normal part of the job” declined by 9%. Despite these gains, negative perceptions of the reporting tool persisted. Impact: This project demonstrates the power of locally focused, leadership-driven change in shifting workplace culture toward greater transparency and safety. Interventions successfully encouraged reporting, though further improvements in reporting systems are needed to sustain long-term progress.