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Other Hazards in Pharmacy Setting

Workplace Violence

Violence in hospitals usually results from patients and occasionally from their family members who feel frustrated, vulnerable, and out of control.

Violence against pharmacists differs from violence experienced by other healthcare workers. Increasingly, pharmacists face violence from robberies at their workplace.

Across the United States, reports of pharmacy robberies specifically related to the theft of OxyContin and Vicodin have been reported. These prescription pain killers may be used for the robber’s own addiction or sold on the street for a significant amount of money.

Violence Prevention Program

OSHA recommends employers establish and maintain a violence prevention program as part of their facilities safety and health program. The program could include:

panic button
  • installing plexiglass in the payment window of the pharmacy area
  • providing better visibility and lighting in the pharmacy area
  • providing training for staff in recognizing and managing hostile and assaultive behavior
  • implementing security devices such as:
    • panic buttons
    • beepers
    • surveillance cameras
    • alarm systems
    • two-way mirrors
    • card-key access systems
    • security guards

Violence Effects

The effects of violence can range in intensity and include the following:

  • minor physical injuries
  • serious physical injuries
  • temporary and permanent physical disability
  • psychological trauma
  • death

Violence may also have negative organizational outcomes such as low worker morale, increased job stress, increased worker turnover, reduced trust of management and co-workers, and a hostile working environment.

Violence Prevention Programs

A program for workplace violence prevention, incorporated into an organization's overall safety and health program, offers an effective approach to reduce or eliminate the risk of violence in the workplace. The building blocks for developing an effective workplace violence prevention program include:

  • Management commitment and employee involvement. Management commitment, including the endorsement and visible involvement of top management, provides the motivation and resources for workers and employers to deal effectively with workplace violence. Through involvement and feedback, workers can provide useful information to employers to design, implement and evaluate the program.
  • Worksite analysis. A worksite analysis involves a mutual step-by-step assessment of the workplace to find existing or potential hazards that may lead to incidents of workplace violence.
  • Hazard prevention and control. After the systematic worksite analysis is complete, the employer should take the appropriate steps to prevent or control the hazards that were identified.
  • Safety and health training. Education and training are key elements of a workplace violence protection program, and help ensure that all staff members are aware of potential hazards and how to protect themselves and their coworkers through established policies and procedures.
  • Recordkeeping and program evaluation. Recordkeeping and evaluation of the violence prevention program are necessary to determine its overall effectiveness and identify any deficiencies or changes that should be made.

Written Violence Prevention Plans

A Violence Prevention Program, in most cases, should include written action plan for job safety and security. In smaller establishments, the program does not necessarily need to include a written plan or a lot of documentation.

Clear goals and objectives are needed to prevent workplace violence. It should be suitable for the size and complexity of the workplace operation and adaptable to specific situations in each establishment. Employers should communicate information about the prevention program and startup date to all employees.

At a minimum, workplace violence prevention plan should:

  • Create and disseminate a clear policy of zero tolerance for workplace violence, verbal and nonverbal threats and related actions. Ensure that managers, supervisors, coworkers, clients, patients and visitors know about this policy.
  • Ensure no employee who reports or experiences workplace violence faces reprisals.
  • Encourage employees to promptly report incidents and suggest ways to reduce or eliminate risks. Require records of incidents to assess risk and measure progress.
  • Outline a comprehensive plan for maintaining security in the workplace. This includes establishing a liaison with law enforcement representatives and others who can help identify ways to prevent and mitigate workplace violence.
  • Assign responsibility and authority for the program to individuals or teams with appropriate training and skills. Ensure that adequate resources are available for this effort and that the team or responsible individuals develop expertise on workplace violence prevention in health care and social services.
  • Affirm management commitment to a worker-supportive environment that places as much importance on employee safety and health as on serving the patient or client.
  • Set up a company briefing as part of the initial effort to address issues such as preserving safety, supporting affected employees and facilitating recovery.

Value of Screening Surveys


One important screening tool is an employee questionnaire or survey to get employees' ideas on the potential for violent incidents and to identify or confirm the need for improved security measures. Detailed baseline screening surveys can help pinpoint tasks that put employees at risk.

Periodic surveys—conducted at least annually or whenever operations change or incidents of workplace violence occur—help identify new or previously unnoticed risk factors and deficiencies or failures in work practices, procedures or controls. Also, the surveys help assess the effects of changes in the work processes. The periodic review process should also include feedback and follow-up.

Independent reviewers, such as law enforcement or security specialists and insurance safety auditors, may offer advice to strengthen programs. These experts can also provide fresh perspectives to improve a violence prevention program.

Conducting a Workplace Security Analysis

The team or coordinator should periodically inspect the workplace and evaluate employee tasks to identify hazards, conditions, operations and situations that could lead to violence.

To find areas requiring further evaluation, the team or coordinator should:

  • Analyze incidents, including the characteristics of assailants and victims, an account of what happened before and during the incident, and the relevant details of the situation and its outcome. When possible, obtain police reports and recommendations.
  • Identify jobs or locations with the greatest risk of violence as well as processes and procedures that put employees at risk of assault, including how often and when.

Employer Responses to Incidents of Violence


Post-incident response and evaluation are essential to an effective violence prevention program. All workplace violence programs should provide comprehensive treatment for employees who are victimized personally or may be traumatized by witnessing a workplace violence incident.

Injured staff should receive prompt treatment and psychological evaluation whenever an assault takes place, regardless of its severity. Provide the injured person(s) transportation to medical care, if it is not available onsite.

Victims of workplace violence suffer a variety of consequences in addition to their actual physical injuries. These may include:

  • short-and long-term psychological trauma
  • fear of returning to work
  • changes in relationships with coworkers and family
  • feelings of incompetence, guilt, powerlessness
  • fear of criticism by supervisors or managers

For more information on preventing workplace violence in the healthcare setting, see OSHAcademy course 776 Preventing Workplace Violence in Healthcare.

Ergonomics Hazards


Ergonomics is the science of fitting the job to the worker. Pharmacists may be exposed to musculoskeletal disorders (MSDs), such as carpal tunnel syndrome, tendonitis, and tenosynovitis from activities that involve repetitive tasks, forceful exertions, awkward postures or contact stress, such as opening/closing bottle lids.

The work of pharmacists generally consists of computer workstation tasks, such as entering and verification of medication orders. Technicians also carry, lift, push, and pull materials, which can contribute to both chronic and acute injuries.

In the next tab, we'll take a closer look at these types of injuries.

Acute Injuries

Acute injuries are those that occur immediately after a single traumatic event, such as lifting a heavy box of supplies and hurting your lower back or slipping on a wet floor and twisting your ankle.

Chronic Injuries

Chronic injuries occur over time as a result of repeated overuse of a certain body part. Symptoms can develop in the affected part and may lead to recurring discomfort. Here are some examples of chronic injuries:

  • shoulder, elbow, or wrist tendinitis from repetitive reaching
  • wrist pain from repetitive typing at a computer workstation
  • sore feet, swelling of the legs, varicose veins, general muscular fatigue, low back pain, stiffness in the neck and shoulders from prolonged standing

Here are some possible solutions to help prevent MSDs in a pharmacy setting:

  • Use assistive devices to eliminate the need to do the task (e.g., use devices designed to open bottle lids for pharmacists)
  • Modification of pharmacy tasks to decrease incidence of work-related MSDs
  • Provide ergonomically comfortable work stations including:
    • wrist pads
    • adjustable padded chairs
    • anti-fatigue mats
    • keyboard tray
    • monitors at a comfortable height

For general information on preventing ergonomic injuries, please see OSHAcademy course 711 Introduction to Ergonomics.


Before beginning this quiz, we highly recommend you review the module material. This quiz is designed to allow you to self-check your comprehension of the module content, but only focuses on key concepts and ideas.

Read each question carefully. Select the best answer, even if more than one answer seems possible. When done, click on the "Get Quiz Answers" button. If you do not answer all the questions, you will receive an error message.

Good luck!

1. How does violence against pharmacists differ from violence against others in the healthcare field?

2. Employers should communicate information about the violence prevention program and startup date to _____ employees.

3. Which of the following is listed as a consequence of violence in the workplace?

4. Which type of ergonomic injury occurs immediately after a single traumatic event?

5. Wrist pain from repetitive typing at a computer workstation is what type of ergonomic injury?

Have a great day!

Important! You will receive an "error" message unless all questions are answered.