WORKPLACE VIOLENCE IN HEALTH CARE FACILITIES

1. PA Training for Health & Safety (PATHS) WORKPLACE VIOLENCE IN HEALTH CARE FACILITIES PPT-046-01 1

2. Definition of workplace violence • Examples of workplace violence • Who is at risk • Effects of workplace violence • Risk factors • Prevention strategies • What to do What We Will Talk About PPT-046-01 2

3. “A violent act (or acts) including physical assaults or threats of assaults directed towards a person at work or while on duty” • CDC/NIOSH, Occupational Hazards in Hospitals, • 2002 Workplace Violence- Definition PPT-046-01 3

4. More than 18 million health care workers today are at high risk to experience workplace violence (80 percent are women) • - CDC National Institute for Occupational Safety and Health (NIOSH) • Of all non-fatal and violent acts that occurred in the workplace, about 60 percent occurred in the health care and social assistance industry • - Bureau of Labor Statistics, 2010 Facts PPT-046-01 4

5. Threats – intent to cause physical harm • Verbal (in person or by telephone) • Written (by letter, by fax or by telephone) Examples of Workplace Violence PPT-046-01 5

6. Intimidation/Harassment: More Examples Psychological – making statements that are: • False • Malicious • Disparaging • Derogatory • Rude • Disrespectful • Abusive • Obnoxious • Insubordinate • With intent to hurt other’s reputation PPT-046-01 6

7. Intimidation/Harassment: More Examples Physical – • Holding • Impeding • Blocking one’s movement • Following • Stalking • Touching • Any other inappropriate contact/advances PPT-046-01 7

8. Assault – causing physical or emotional injury, pain or distress • Hitting, slapping, punching, pushing, poking and kicking • Also shouting, name calling, use of derogatory language • May include use of a firearm, bomb or knife Examples PPT-046-01 8

9. In general, anyone who works in a hospital or health care setting (nursing home, assisted living, health clinic, etc.) • Specifically, nurses and aides with the most direct contact with patients, during: • Meal time • Visiting hours • Patient transportation • Administering care, including bathing Who Is At Risk? PPT-046-01 9

10. Others at risk include: • Emergency response personnel • (police, fire, ambulance, volunteers) • Hospital safety/security officers • Other health care providers Who Is At Risk? PPT-046-01 10

11. Waiting rooms • Emergency • rooms • Psychiatric wards • Patient rooms • Geriatric units • Outside facility (parking lots) Where It Occurs PPT-046-01 11

12. Minor or major physical injuries • Temporary or permanent physical disability • Psychological trauma • Death Direct Effects of Violence PPT-046-01 12

13. Low worker morale • Increase in job stress • Increase in worker turnover • Reduced trust of management/co-workers • A hostile work environment Indirect Effects of Workplace Violence PPT-046-01 13

14. Working with volatile people (e.g., those who are under the influence of alcohol/drugs, have a history of violence or are diagnosed as psychotic) • Working when understaffed or working alone • Transporting patients • Long waits for service • Overcrowded waiting rooms • Poorly-lit areas (parking lots, corridors) • Inadequate security • Unrestricted movement of the public Risk Factors PPT-046-01 14

15. Develop a comprehensive prevention program that includes: • Zero tolerance policy • Management commitment/enforcement • Employee participation • Hazard identification • Training • Hazard prevention • Accurate and timely reporting Violence Prevention PPT-046-01 15

16. Engineering • Including installation of: • Emergency alarms • Signaling and monitoring systems • Security devices (metal detectors, cameras) • Better lighting • Enclosed nurses’ stations • Bullet-proof/shatter-proof glass enclosures at reception areas Prevention Strategies PPT-046-01 16

17. Changing Behavior • Create “buddy system” • Provide security escorts to parking lots • Prevent personnel from working alone • Restrict movement of public using controlled-access cards Prevention Strategies PPT-046-01 17

18. Changing Behavior Prevention Strategies • Training in hazard awareness, resolving conflicts, • recognizing potential signs • Make counseling available to reduce workers’ fear • Have open communication with workers PPT-046-01 18

19. Administrative Controls • Comprehensive, written procedures for reporting and for responding to occurrences • Enforce zero-tolerance policy • Update program as necessary (continuous improvement) Prevention Strategies PPT-046-01 19

20. Verbally-expressed anger or frustration • Body language or threatening gestures • Signs of alcohol or drug use • Presence of a weapon (firearm, knife, etc.) Signals PPT-046-01 20

21. Present a calm, caring attitude • Don’t match the threat • Don’t give orders • Acknowledge what the person feels • Avoid aggressive behavior What to do PPT-046-01 21

22. Evaluate each situation • Be vigilant • Do not isolate yourself • Always keep an open path for exiting What else PPT-046-01 22

23. Remove yourself from the situation • Call security for help • Report any violent situations to management Unable to Diffuse PPT-046-01 23

24. OSHA 3148 – Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers (2004) • www.osha.gov • CDC/NIOSH – Workplace Violence – Healthcare Workers • www.cdc.gov References PPT-046-01 24

25. House Bill 1992 • - Health Care Facilities Workplace Violence Prevention Act • - Submitted to State Assembly in November 2011 by State Representative Nicholas Micozzie (R-163); joint effort with Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP) • - Pending in House Committee (Health) as of Nov. 16, 2011 Commonwealth Reference PPT-046-01 25

26. Questions PPT-046-01 26