Workplace violence rules, and the training method they share
Four rules ask hospital staff to rehearse de-escalation with colleagues: the Joint Commission, California, Nevada and Washington.
By Kim Loza, Head of Product at People Tech Revolution
The moment
An agitated visitor, and a colleague beside you
The hardest part of workplace violence prevention happens at a triage desk or on a ward at night. The rules ask staff to have rehearsed it together first, which is the core of de-escalation training for healthcare workers.
Why these rules exist
Health care carries most of the injury
The rules answer a measured problem. In 2018, violence injured private health care and social assistance workers at five times the rate of workers overall, and psychiatric hospitals at far more.
Nonfatal injuries from violence by another person, by industry.
Source: U.S. Bureau of Labor Statistics, Workplace Violence in Healthcare, 2018, table 1.
Reported to the accreditor
Hospitals report their most serious harms to the Joint Commission as sentinel events. Reports of assault, rape and homicide rose from 53 (2020) to 106 (2023), then fell to 65 (2024).
The Joint Commission warns that reporting is voluntary, so the counts show what was reported, not how often violence happens. In 2024, 27% of the assaults reported were by a patient on staff.
See the data (reports)
| 2020 | 2021 | 2022 | 2023 | 2024 | |
|---|---|---|---|---|---|
| reported events | 53 | 60 | 67 | 106 | 65 |
Source: The Joint Commission, Sentinel Event Data 2024 Annual Review.
The rules
Written apart, saying the same thing
An accreditor, a state health standard and two state statutes were written by different bodies for different reasons.
California
California’s workplace violence prevention standard for health care requires an opportunity to practise the techniques with the other employees a worker will work with, including a meeting to debrief the practice session.
Nevada
Nevada’s statute asks medical facilities for the same practice with colleagues and a meeting to debrief each practice session, and adds a record of each training session.
Washington
Washington’s law requires violence prevention training within ninety days of hire in every health care setting, and names strategies to prevent physical harm with hands-on practice or role play.
The Joint Commission
The Joint Commission’s workplace violence performance goal asks hospitals to train leaders, staff and licensed practitioners at hire, annually and whenever the program changes.
The method
Practise, debrief, keep the record
Read together, they describe how a skill is built: repetition with the people you work beside, feedback straight after, and proof it happened.
Where training sits
Training earns its place through rehearsal
Australian rules reach the same point from the other direction, by ranking what each control can do.
The NSW healthcare code
The Healthcare and social assistance industry Code of Practice places training among administrative controls, and calls administrative controls and personal protective equipment the least effective, because they rely on human behaviour or supervision.
A control that depends on behaviour is as strong as the rehearsal behind it. That is why the American instruments specify a method.
Australian hospitals
The NSQHS Clinical Governance Standard asks for a mandatory training program at Action 1.20, and the Comprehensive Care Standard asks for de-escalation strategies at Action 5.34.
Delivery
Rehearsal for the whole roster
A role-play needs a second person to act the difficult part, a room, a facilitator and an hour when neither is on the floor.
Rehearsal at roster scale
Across night shifts, agency staff and each graduate intake, those four needs are the constraint. It is why a method every regulator recommends so often arrives as a slide deck.
Practice that fits the roster
Staff rehearse in a VR headset or with an AI roleplay partner in a browser, then debrief with a colleague. See VR de-escalation training and how classroom de-escalation programs compare.
Questions
What safety and clinical leads ask
Short answers to the questions that follow a first reading of the rules.
Does this apply outside healthcare?
The four instruments cover health care settings. In aviation, ACRP Research Report 280 recommends scenario-based training or role-playing for airport badgeholders. See training for airport and airline staff.
Which instrument applies to us?
The state-by-state guide to US workplace violence training maps the American rules, and occupational violence rules in Australia sets out the Australian codes.
What does a surveyor ask for?
Evidence that staff trained and practised. The guide to workplace violence training records covers what each instrument asks you to keep.
- California workplace violence training
- Nevada workplace violence training
- Washington violence prevention training
- Joint Commission workplace violence goal
Cite this research
Free to quote and cite with a link to this page. Name the version you read, so readers can see what has changed since.
APA 7
Loza, K. (2026, September 24). Workplace violence rules, and the training method they share (Version 1.1). People Tech Revolution. https://peopletechrevolution.com/insights/four-regulators-one-method
Data: Each rule read at its source when this version was written, on 20 September 2026. Every instrument is linked in Sources.
Version history
| Version | Date | What changed |
|---|---|---|
| Version 1.1 | Added US injury rates by industry (Bureau of Labor Statistics) and Joint Commission sentinel event reports, 2020 to 2024. | |
| Version 1.0 | First published. |
Planning workplace violence training?
Sources
Each rule in full, on the regulator’s own site.
Workplace Violence in Healthcare, 2018
Injury rates by industry, table 1.
Sentinel Event Data 2024 Annual Review
Violence-related sentinel event reports, 2020 to 2024, and who the 2024 assaults were by.
Workplace Violence Prevention in Health Care
Practice with the employees a worker will work with, and a meeting to debrief it.
Chapter 618, Occupational Safety and Health
Practice with colleagues, a debrief of each session, and a record of each training session.
RCW 49.19.030: Violence prevention training
Training within ninety days of hire, with hands-on practice or role play.
Preventing workplace violence
The national performance goal on workplace violence for United States hospitals.
Codes of practice
Includes the Healthcare and social assistance industry Code of Practice.
Clinical Governance Standard
Action 1.20: a mandatory training program, with participation monitored.
Comprehensive Care Standard
Action 5.34: identify patients at risk of aggression and implement de-escalation strategies.
Reducing and Managing Disruptive and Unruly Behavior in Airports
Recommends scenario-based training or role-playing for airport badgeholders.
