Curbing Workplace Violence in Healthcare Settings: Approaches From the WHO and OSHA

Quick Hits

• The WHO and several other organizations have jointly developed “Framework Guidelines for Addressing Workplace Violence in the Health Sector,” signaling a unified global commitment to ending workplace violence in healthcare.
• Despite the absence of a federal OSHA standard, the agency is actively investigating and citing employers that fail to protect healthcare workers from workplace violence.
• Several states have also taken the initiative to provide workplace violence prevention requirements in healthcare settings.

Worldwide, up to 38 percent of healthcare workers experience physical violence during their careers, and the toll extends far beyond bruises and broken bones. The consequences are far-reaching for workers, patients, and healthcare systems. The WHO, along with several other organizations, has made this issue a priority by developing “Framework Guidelines for Addressing Workplace Violence in the Health Sector.” These guidelines support the development of violence prevention policies and data collection efforts in both nonemergency and emergency settings. In the United States, the Occupational Safety and Health Administration (OSHA) has recognized the same issue as “serious” and “longstanding.”

The number of violent incidents against healthcare workers is staggering. Not only does it have a negative impact on the psychological and physical well-being of healthcare employees, but it also compromises quality of care for patients. The WHO estimates that between 8 percent and 38 percent of healthcare workers worldwide experience physical violence at some point in their careers, with many more exposed to verbal aggression. In the United States, nearly 20 percent of healthcare workers report experiencing physical abuse in the workplace. These are not abstract statistics—they represent nurses assaulted during shifts, emergency room staff threatened at knifepoint, and behavioral health workers enduring daily hostility. Both the WHO and OSHA have taken proactive approaches to confront this crisis.

The WHO’s Call to Action

The WHO, the International Labour Organization (ILO), the International Council of Nurses (ICN), and Public Services International (PSI) jointly developed “Framework Guidelines for Addressing Workplace Violence in the Health Sector.” These guidelines support the development of workplace violence prevention policies in non-emergency settings and provide a questionnaire and study protocol to research the magnitude and consequences of violence in healthcare. For emergency settings, the WHO developed methods to systematically collect data on attacks against healthcare facilities, workers, and patients—an essential step toward understanding a problem that is too often underreported and poorly tracked.

Where OSHA Stands in 2026

In the United States, OSHA has long identified a workplace violence prevention standard for healthcare as a priority. In March 2023, OSHA convened a Small Business Advocacy Review (SBAR) panel to consider a potential standard for the prevention of workplace violence in healthcare and social assistance fields. The panel heard from a broad cross-section of stakeholders, including representatives from hospitals, residential behavioral health facilities, ambulatory treatment centers, home healthcare agencies, emergency medical services, and correctional health settings. While OSHA had originally planned to publish a notice of proposed rulemaking (NPRM) in June 2025, the spring 2025 regulatory agenda moved the proposed rule to the long-term action category, and a date for the NPRM is now “To Be Determined.”

In the meantime, OSHA continues to enforce the General Duty Clause (Section 5(a)(1)) of the Occupational Safety and Health (OSH) Act, which requires healthcare employers to maintain a workplace free from recognized hazards likely to cause death or serious physical harm. Circuit courts have indicated a willingness to uphold General Duty Clause citations involving healthcare facilities and workplace violence, making it clear that healthcare employers cannot treat the lack of a dedicated standard as a shield against accountability.

States Filling in the Gap

While the federal standard remains in limbo, several states have moved forward with their own workplace violence prevention requirements. In recent years, states including California, Kentucky, Utah, Virginia, and Washington have introduced or enacted legislation specifically addressing workplace violence in healthcare settings.

Kentucky offers a useful case study. In 2023, Kentucky passed House Bill (HB) 176, requiring health facilities to develop and execute workplace safety assessments and safety plans aimed at identifying and mitigating the risk of violence against healthcare workers. The law mandates annual training, recordkeeping, and internal reporting systems with annual compliance audits. In February 2026, a bill was introduced to strengthen the law further, proposing, among other things, that healthcare facilities display prominent notices warning of potential consequences for threatening or aggressive behavior toward healthcare workers.

Meanwhile, in Washington, a recent amendment to RCW 49.19.020 added a new section establishing investigation requirements for workplace violence incidents in healthcare settings.

Next Steps

Even in the absence of a federal standard, the importance of workplace violence prevention in healthcare settings is clear. The WHO’s framework, OSHA enforcement actions, and state-level mandates all point in the same direction—healthcare facilities and employers must take proactive measures to address workplace violence and protect employees.

At a minimum, employers may want to review OSHA’s guidance on preventing workplace violence in healthcare settings. OSHA states in the guidance: “One of the best protections healthcare employers can offer their workers is to establish a zero-tolerance policy toward workplace violence.” Such workplace violence prevention policies should cover all employees, patients, and visitors, according to the guidance.

Ogletree Deakins’ Healthcare Industry Group and Workplace Violence Prevention Practice Group will continue to monitor developments and will post updates on the firm’s Healthcare, Workplace Safety, and Workplace Violence Prevention blogs as additional information becomes available.

Follow and Subscribe
LinkedIn | Instagram | Webinars | Podcasts