Workplace Violence

1. Workplace Violence AMITA Health Security

2. Objectives • Understanding Workplace Violence and the program that is in place at AMITA Health • What is Workplace Violence • Early warning signs • Safe body space parameters/positioning • Intervention • Reporting process • Policy

3. Definition AMITA Health’s Policy defines Workplace Violence as any threat or action (verbal, written or physical aggression) or any form of harassment that occurs in the workplace, which is intended to control or cause, or is capable of causing death, serious bodily injury or psychological harm to oneself or others, or damage to property.

4. Workplace Violence in Healthcare • More assaults occur in healthcare than in any other industry. • The Bureau of Labor Statistics reports that more than 70% of reported significant injuries due to assault at work, occurred in a healthcare or social service setting (US Department of Labor 2015). • The Bureau of Labor Statistics reports that violence related injuries are four times more likely to cause health care workers to miss work than any other type of injury.

5. Workplace Violence in Healthcare • Workplace Violence is severely underreported. • The Joint Commission issued a Sentinel Event Alert focusing on physical and verbal violence against healthcare workers. According to this: • Only 30% of nurses report incidents of violence. • Many healthcare workers consider violence to be “part of the job.” • May believe the patient is not responsible for their actions due to conditions affecting their mental state.

6. Workplace Violence in Healthcare Data Source: Bureau of Labor Statistics for intentional injuries caused by humans, excluding self-inflicted injuries.

7. Reasons Violence Occurs There are many reasons why healthcare settings have a higher occurrence of workplace violence incidents. Some contributing factors include. • Working with people who have a history of violence • Stress / Fear / Anxiety • Helplessness • Feeling that their privacy or personal space is being invaded • Working with people under the influence of drugs or alcohol • Lifting, moving and transporting patients • Working alone • Unrestricted public access • Perception that violence is tolerated and reporting will have no effect

8. AMITA Health Policy on Workplace Violence • AMITA Health is concerned and committed to the safety and health or our associates, medical staff, patients and visitors. • AMITA Health has a zero tolerance policy related to violence in the workplace, and will make every effort to prevent incidents from occurring by implementing a Workplace Violence Prevention Program. • AMITA Health’s Workplace Violence Policy can be found in PolicyStat off of the iAmita home page.

9. Workplace Violence Prevention • AMITA Health has a program in place to make efforts to reduce violence in the workplace. • Examples of this include: • Annual security assessments completed to identify security concerns and provide recommendations for continual improvements. • Ongoing security training that reviews early detection of and response to violence. • Written policy • Safety/Security Subcommittees that review violent incidents to identify opportunities for improvement and assess threats.

10. Recognizing Violent Behavior • It is important to recognize early signs that violent behavior is possible before a situation becomes violent. • Verbal signs may include: • Use of profanity • Angry or threatening tone of voice • Shouting or screaming • Making unreasonable demands • Emotional overreaction • Expressing irrational thinking • Rapid speech • Threatening statements

11. Recognizing Violent Behavior • Physical signs may include: • Nervous pacing or restlessness • Constantly moving or repositioning • Aggressive stance • Clenching of fists or jaw • Gripping objects tightly • Change in appearance or habits • Wringing hands

12. Associate Safety – Physical Environment • It is important to always be aware of your surroundings when you are in a situation that could escalate or become violent. • Always have an exit. If in a patient room, associates should position themselves between the patient and the door • Be aware of your proximity to the individual • Keep a safe distance – do not try and get close to the individual to comfort them or try to calm them down • Do not box individual in or surround them. If people feel cornered, most obtain a fight or flight mentality. • Assess area for weapons of opportunity • Patient belongings • Medical equipment/items in room • Most anything can be used as a weapon

13. Associate Safety – Physical Environment

14. Body Space Parameters Body space parameters are very important. By positioning yourself appropriately you can help keep yourself safe from physical violence. Important: Action is quicker than reaction. While in the Intimate Space you are at your most vulnerable to violence. If the person has already acted out or is showing signs of escalation you should not enter the Intimate Space without appropriate staff support.

15. Response • As soon as signs of escalation are present you should call for assistance • Non urgent assistance can be requested by dialing your security department extension • Try to stay calm and focused on the individual • It is important to speak to the individual in a calm voice • Do not raise your voice or become defensive • Start sentences with “I” and not “you”. Examples of this would be “I understand” or “I hear you explaining” and not “you need to” or “you can’t”.

16. Response • Listen to the individual. Many times, the individual just needs someone to hear them voice their frustration. • Repeat back what you are hearing to demonstrate you hear and understand what they are saying to you. • Give clear instructions and set boundaries. Avoid negotiating with the individual.

17. Response • If the situation continues to escalate or the previous steps are not effective, the associate should immediately remove themselves from the area and call for urgent help • Urgent security assistance can be called by dialing your emergency response number. • Alexian locations – 911and initiate a Security Emergency • Adventist locations – 555 and initiate a Security Emergency • Offsite locations – 911 for police assistance • Some locations have duress buttons. These can also be utilized to request immediate response from security.

18. Reporting Associates can help to make the workplace safer by reporting all situations that seem out of the ordinary and all incidents of violence or threatened violence. Associates should understand that violence is not part of their job and they have the right to a safe work environment. All incidents should be reported and taken seriously. Associates should contact security to report non urgent incidents and their emergency notification number to report urgent incidents.

19. Reporting • Certain disruptive, threatening or violent behavior is prohibited under criminal or civil law. When appropriate, the health system will refer cases for civil action or criminal prosecution. Police intervention will be facilitated by the responding security officer. • Victims have the option to file a police report. Security will help facilitate this if the associate chooses. • Security will document incidents using a security report, as appropriate.

20. Other Considerations – Orders of Protection • The Health System wants to provide a safe environment and protect associates from threats to their safety. As a result, it is necessary that the Health System be informed about individuals who have been ordered by the courts, or other legally constituted entities that an individual(s) have been restricted from personnel or campus. • Associates who apply for or obtain a protective or restraining order should notify their supervisor and security. They should also provide a copy of the order to security.

21. Other Considerations – Weapons on Property • Individuals are prohibited from bring any type of weapon onto AMITA Health System property. Exception: Law enforcement will be allowed to carry their weapons on our property in accordance with their policies and procedures. • If any individual is noticed to be in possession of a firearm or other type of weapon within our facilities, contact the Security Department to notify them of the situation. Associates should not attempt to intervene on their own and should always let Security handle this interaction. • Associates play a very important role in maintaining a safe environment. If you see something out of the ordinary, this should be reported by contacting the Security Department.