Other Titles
Integrating a Violence Risk Assessment Tool into the EHR: A Nursing Informatics-Led Quality Improvement Initiative [Title Slide]
Abstract
In October 2022, a tragic act of workplace violence within our health system highlighted the need for a proactive, data-driven approach to staff safety. Workplace violence impacts nearly one in four nurses each year (McCollum et al., 2024); yet most organizations lack an objective tool to predict and prevent such incidents. The goal of this project was to implement and evaluate a systematic, evidence-based screening process to improve early risk detection and foster safer clinical environments—aligned with the AACN Healthy Work Environment Standard of Effective Decision-Making (AACN, 2016).
A multidisciplinary team of nursing, informatics, and security leaders integrated a modified Brøset Violence Checklist (BVC)—a validated tool for predicting short-term aggression (Hvidhjelm et al., 2023)—into the electronic health record (EHR). This workflow allowed real-time documentation, automated risk scoring, and visibility of patient risk across disciplines. When thresholds were met, the EHR triggered a standardized response bundle that included a safety banner, a security notification, an individualized care plan, and nurse-to-nurse handoff communication. This created consistent, scalable safety procedures across all inpatient units.
Since the implementation in 2023, 108,281 screenings have been completed. Of these, 1,022 patients (0.9%) were identified as at risk, and 10 patients later committed violent acts—data that were previously unavailable for analysis. The initiative provided measurable insights into violence risk, improved staff communication, and increased confidence in proactive safety measures. Qualitative feedback showed stronger trust in leadership and improved collaboration.
The data now serve as a key performance indicator (KPI) for leadership, guiding decisions about de-escalation training, resource allocation, and recognition of frontline safety efforts. By embedding an evidence-based tool within the EHR, this project demonstrates a repeatable, scalable model that supports effective communication, authentic leadership, and true collaboration—core AACN standards vital to a healthy work environment. Attendees will learn practical strategies for integrating safety and technology to promote both psychological and physical well-being across healthcare settings.
Notes
Presenter notes available in attached slide deck.
Reference list included in attached slide deck.
Sigma Membership
Iota Nu at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Quality Improvement
Research Approach
Translational Research/Evidence-based Practice
Keywords:
lncivility, Health Equity or Social Determinants of Health, Equity, Bias, Inclusivity, Violence in the Workplace, Safety, Offensive Behavior, Socioeconomic Disparities in Health, Health Equity
Recommended Citation
Bradford, Kirk, "EHR Integration of a Violence Risk Tool to Promote Safer Work Environments" (2026). Creating Healthy Work Environments (CHWE). 13.
https://www.sigmarepository.org/chwe/2026/presentations_2026/13
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-04-22
EHR Integration of a Violence Risk Tool to Promote Safer Work Environments
Washington, DC, USA
In October 2022, a tragic act of workplace violence within our health system highlighted the need for a proactive, data-driven approach to staff safety. Workplace violence impacts nearly one in four nurses each year (McCollum et al., 2024); yet most organizations lack an objective tool to predict and prevent such incidents. The goal of this project was to implement and evaluate a systematic, evidence-based screening process to improve early risk detection and foster safer clinical environments—aligned with the AACN Healthy Work Environment Standard of Effective Decision-Making (AACN, 2016).
A multidisciplinary team of nursing, informatics, and security leaders integrated a modified Brøset Violence Checklist (BVC)—a validated tool for predicting short-term aggression (Hvidhjelm et al., 2023)—into the electronic health record (EHR). This workflow allowed real-time documentation, automated risk scoring, and visibility of patient risk across disciplines. When thresholds were met, the EHR triggered a standardized response bundle that included a safety banner, a security notification, an individualized care plan, and nurse-to-nurse handoff communication. This created consistent, scalable safety procedures across all inpatient units.
Since the implementation in 2023, 108,281 screenings have been completed. Of these, 1,022 patients (0.9%) were identified as at risk, and 10 patients later committed violent acts—data that were previously unavailable for analysis. The initiative provided measurable insights into violence risk, improved staff communication, and increased confidence in proactive safety measures. Qualitative feedback showed stronger trust in leadership and improved collaboration.
The data now serve as a key performance indicator (KPI) for leadership, guiding decisions about de-escalation training, resource allocation, and recognition of frontline safety efforts. By embedding an evidence-based tool within the EHR, this project demonstrates a repeatable, scalable model that supports effective communication, authentic leadership, and true collaboration—core AACN standards vital to a healthy work environment. Attendees will learn practical strategies for integrating safety and technology to promote both psychological and physical well-being across healthcare settings.
Description
A multidisciplinary team integrated a modified Brøset Violence Checklist into the EHR to enhance early identification of patients at risk for violence. Automated alerts and standardized response bundles improved safety, communication, and collaboration. Outcomes demonstrate measurable increases in staff confidence, proactive safety behaviors, and alignment with AACN Healthy Work Environment Standards.