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WORKPLACEVIOLENCEPREVENTIONHealthCareandSocialServiceWorkers

Definition

Workplaceviolenceisanyphysicalassault,threateningbehavior,orverbalabuseoccurringintheworksettingAworkplacemaybeanylocationeitherpermanentortemporarywhereanemployeeperformsanywork-relatedduty DefinitionCont’dThisincludes,butisnotlimitedto,thebuildingsandthesurroundingperimeters,includingtheparkinglots,fieldlocations,clients’homesandtravelingtoandfromworkassignmentsExamplesVerbalthreatstoinflictbodilyharm;includingvagueorcovertthreatsAttemptingtocausephysicalharm;striking,pushingandotheraggressivephysicalactsagainstanotherpersonExamplesVerbalharassment;abusiveoroffensivelanguage,gesturesorotherdiscourteousconducttowardssupervisors,fellowemployees,orthepublicDisorderlyconduct,suchasshouting,throwingorpushingobjects,punchingwalls,andslammingdoorsExamplesMakingfalse,maliciousorunfoundedstatementsagainstcoworkers,supervisors,orsubordinateswhichtendtodamagetheirreputationsorunderminetheirauthorityExamplesInappropriateremarks,suchasmakingdelusionalstatementsFascinationwithgunsorotherweapons,bringingweaponsintotheworkplaceStatisticsonWorkplaceViolenceHomicideisthesecondleadingcauseofdeathintheworkplaceIn1997,therewere856homicidesinAmerica’sworkplacesAssaultsandthreatsofviolencenumberalmost2millionayearAssaultsandHomicidesPrevalenceofhandgunsandotherweaponsamongpatients,theirfamilies,orfriendsIncreasinguseofhospitalsbythecriminaljusticesystemforcriminalholdsandthecareofacutelydisturbed,violentindividualsRiskFactorsRiskFactors(cont’d)Increasingnumberofacuteandchronicallymentallyillpatientsbeingreleasedfromhospitalswithoutfollow-upcare,whonowhavetherighttorefusemedicineandwhocannolongerbehospitalizedinvoluntarilyunlesstheyposeathreattothemselvesorothersRiskFactors(cont’d)Availabilityofdrugsandmoneyathospitals,clinicsandpharmacies,makingthemlikelyrobberytargetsUnrestrictedmovementofthepublicinclinicsandhospitalsRiskFactors(cont’d)Presenceofgangmembers,drug/alcoholabusers,traumapatients,distraughtfamilymembersLowstaffinglevelsduringtimesofincreasedactivitysuchasmealandvisitingtimes,transportingofpatientsRiskFactors(cont’d)IsolatedworkwithclientsduringexamsortreatmentSolowork,ofteninremotelocations,highcrimesettingswithnoback-upormeansofobtainingassistancesuchascommunicationdevicesoralarmsystems

OSHA’sCommitment

OSHAhasdevelopedguidelinestoprovideinformationtoassistemployersinmeetingtheirresponsibilitiesundertheOSHAct.OSHAGuidelinesBasedonOSHA’sSafetyandHealthProgramManagementGuidelinespublishedin1989OSHAGENERALDUTYCLAUSE:

SECTION5(a)(1)

EachemployershallfurnishtoeachofhisemployeesemploymentandaplaceofemploymentwhicharefreefromrecognizedhazardsthatarecausingorlikelytocausedeathorseriousphysicalharmThisincludesthepreventionandcontrolofthehazardofworkplaceviolenceWorkplaceViolence

PreventionProgramElementsManagementCommitmentandEmployeeInvolvementWorksiteAnalysisHazardPreventionandControlTrainingandEducationRecordkeepingandEvaluationofProgramManagementCommitment

andEmployeeInvolvement

ComplementaryandessentialManagementcommitmentprovidesthemotivatingforcetodealeffectivelywithworkplaceviolenceEmployeeinvolvementandfeedback-enableworkerstodevelopandexpresstheircommitmenttosafetyandhealthManagementCommitmentOrganizationalconcernforemployeeemotionalandphysicalsafetyandhealthEqualcommitmenttoworkersafetyandhealthandpatient/clientsafetySystemofaccountabilityforinvolvedmanagers,andemployeesManagementCommitment(cont’d)OutlineacomprehensiveplanformaintainingsecurityintheworkplaceAssignresponsibilityandauthorityforprogramtoindividualswithappropriatetrainingandskillsAffirmmanagementcommitmenttoworkersupportiveenvironmentSetupcompanybriefingsaspartoftheinitialefforttoaddresssafetyissuesEmployeeInvolvementUnderstandandcomplywiththeworkplaceviolencepreventionprogramandothersafetyandsecuritymeasuresParticipateinemployeecomplaintsorsuggestionprocedurescoveringsafetyandsecurityconcernsPromptandaccuratereportingofviolentincidentsWorksiteAnalysisStep-by-steplookattheworkplace,tofindexistingorpotentialhazardsforworkplaceviolenceWorksiteAnalysis(cont’d)A“ThreatassessmentTeam”,PatientAssaultTeam,orsimilartaskforcemayassessthevulnerabilitytoworkplaceviolenceanddetermineappropriateactionsWorksiteAnalysis

RecommendedProgramAnalyzingandtrackingrecordsMonitoringtrendsandanalyzingincidentsScreeningsurveysAnalyzingworkplacesecurityHazardPreventionandControlEngineeringcontrolsandworkplaceadaptationAdministrativeandworkpracticecontrolsPostincidentresponseEngineeringControlsAlarmsystemsandothersecuritydevicesMetaldetectorsClosed-circuitvideorecordingforhigh-riskareasSaferoomsforuseduringemergenciesEnclosenurses’station,installdeepservicecountersorbullet-resistantglassinreceptionarea,triage,admittingAdministrativeand

WorkPracticeControlsStateclearlytopatients,clients,andemployeesthatviolencewillnotbetoleratedorpermittedEstablishliaisonwithlocalpoliceandstateprosecutorsRequireemployeestoreportallassaultsandthreatsSetuptrainedresponseteamstorespondtoemergenciesPost-IncidentResponseProvidecomprehensivetreatmentforvictimizedemployeesandemployeeswhomaybetraumatizedbywitnessingaworkplaceviolenceincidentPost-IncidentResponseTrauma-crisiscounselingCriticalincidentstressdebriefingEmployeeassistanceprogramstoassistvictimsTrainingandEducationEnsurethatallstaffareawareofpotentialsecurityhazardsandwaysofprotectingthemselvesWorkplaceViolenceProgramTrainingandEducationEmployeesshouldunderstandconceptof“UniversalPrecautionsforViolence”,i.e.,thatviolenceshouldbeexpectedbutcanbeavoidedormitigatedthroughpreparationEmployeesshouldbeinstructedtolimitphysicalinterventionsinworkplacealtercationsunlessdesignatedemergencyresponseteamorsecuritypersonnelareavailableTrainingandEducationTrainingprogramshouldinvolveallemployees,includingsupervisorsandmanagersTrainingandEducationWorkplaceviolencepreventionpolicyRiskfactorsthatcauseorcontributetoassaultsEarlyrecognitionofescalatingbehaviororwarningsignsWaystopreventvolatilesituationsStandardresponseactionplanforviolentsituationsLocationandoperationofsafetydevices

RecordkeepingandEvaluationRecordkeepingandevaluationoftheviolencepreventionprogramarenecessarytoodetermineoveralleffectivenessandIdentifydeficienciesorchangesthatshouldbemadeRecordkeepingOSHA