Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2023


Doctor of Nursing Practice (DNP)

Primary Advisor

Mary Jean Schumann, DNP, MBA, RN, CPNP, FAAN; Nicholas Alen Chmielewski, DNP, RN, CEN, CENP, NEA-BC, FAEN


Verbal Aggression; Workplace Violence; Nurses


Background: Almost three-quarters of non-fatal workplace violence-related injuries requiring time away from the workplace occur in the healthcare and social services sector. More than 90 percent of assaults against nurses are from patients. Verbal aggression was correlated with physical violence and could contribute to nurses’ stress and dissatisfaction and compromise patient care. Policies and guidelines addressing verbal aggression against nurses are often unclear and not well-supported by evidence. This can leave nurses unprepared to recognize and respond to verbal aggression or threats of physical harm without compromising their safety.

Aim: This health policy analysis aimed to explore a range of national, state, and local policies regarding Type II workplace violence against nurses and other disciplines and propose policy modifications addressing verbal aggression to reduce workplace violence-related physical harm.

Methodology: This DNP project followed Bardach’s Eight-Fold Path. Thirty-three research articles were qualified and reviewed to investigate interventions for verbal aggression in healthcare, policing, and education. Forty-six policy documents were qualified and reviewed, including position statements, legislation, regulations, guidelines, and educational documents. Gaps in current policy precluding reducing workplace violence against nurses were identified. Alternatives were formulated and evaluated against criteria. Policy modifications were recommended. A policy brief was created and shared with stakeholders.

Results: The confounding variable complicating guidance for nurses was the ethical obligation of nurses’ duty to care. Reducing WPV will depend on nursing’s ability to rebuild a culture that supports the value and safety of nurses, including empowering nurses to protect themselves from physical violence.

Recommendations: Recommendations for policy modifications supporting early intervention for verbal aggression were provided as these may reduce incidence and injuries to nurses from subsequent physical violence. Submissions included policy modifications and strategies to foster a unified effort from diverse stakeholders.

Open Access


Included in

Nursing Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.