Risk & Business Magazine JGS Insurance Magazine Spring 2019 | Page 8

WORKPLACE VIOLENCE
WORKPLACE VIOLENCE IN
HEALTHCARE FACILITIES
T
he General Duty Clause from
the Occupational Safety
and Health Act of 1970 (Act)
requires all employers to provide
a work environment “free from
recognized hazards that are causing or are
likely to cause death or serious physical
harm.” Workplace violence is a recognized
hazard within the healthcare industry, and
as such, employers have the responsibility
under the Act to abate the hazard.
Healthcare workplace violence leads to
increased absenteeism by healthcare
workers, increased use of sick leave, lower
productivity, low morale and increased
requests for transfers. Violence in the
healthcare workplace is a major disruption
to job satisfaction. It can result in added
costs from workers’ compensation, patient
lawsuits and costs associated with hiring
and training replacement workers due to
staff turnover.
Many factors contribute to the
occupational risks facing healthcare
workers today, but a fundamental problem
is a healthcare culture that focuses more
on patient safety than on worker safety.
Healthcare is not considered a particularly
dangerous profession, yet when violence
does occur, it is often labeled as “part of the
job.”
Management needs to take workplace
violence seriously and implement
procedures to mitigate such incidents.
Three major factors should be considered:
environmental, administrative and training.
Environmental conditions—such as
changes in noise levels, odors and lighting—
can be upsetting to some patients. To
alleviate these conditions, review the
layout, design and amenities of the physical
workspace. Eliminate unmonitored entries
and stairwells, provide sufficient lighting
and provide mirrors on blind corners. Keep
in mind—unsecured furniture, fixtures and
decorative items provide opportunities to
be used as weapons and should be removed
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from the workplace. Consider creating a
barrier between the worker and the violent
person, such as enclosing a worker’s station.
Changes in work practices and
administrative procedures can help
prevent violent incidents by ensuring that
adequate staff are available, especially
at the riskiest times and in the riskiest
areas. Also, make sure no one is working
alone. Develop systems for communicating
relevant information on patient history and
behaviors to all direct care staff, from one
shift to the next.
TRAIN AND EDUCATE
ALL STAFF MEMBERS IN
IDENTIFYING POTENTIAL
VIOLENT BEHAVIORS
AND HOW TO PROTECT
THEMSELVES. FREQUENT
TRAINING ALSO REDUCES
THE LIKELIHOOD OF BEING
ASSAULTED.
Training should include information on
types of injuries or problems identified
in the facility and the methods to control
the specific hazards. Most importantly,
instruct employees on limiting physical
interventions in workplace altercations
whenever possible and train all employees
to behave compassionately when an
incident occurs.
For the healthcare worker, your words
and demeanor have the power to defuse
tensions. Be attuned to your tone of voice,
choice of words and body language. It is
important to be cognizant of and control
your body position and posture so as not
to inadvertently escalate an already tense
situation.
If a patient shows signs of loss of self-
control and problem-solving ability, verbal
and nonverbal interventions can still
be effective but additional precautions
should be taken. The focus now turns
to protecting yourself and those around
you. Observing an out-of-control person is
frightening and may trigger your own “fight
or flight” response. Emotional containment
is important so that proper procedures and
protocols are remembered and followed.
Don’t go it alone; enlist the help of security
or colleagues. Be prepared to use your panic
device and to physically remove yourself, if
necessary. Position yourself to exit easily.
Remove other patients or visitors from the
room. Response to an out-of-control person
may require physical and/or chemical
restraint, in which case you should follow
your healthcare organization’s policies and
procedures for next steps. It is important
that you continue to engage the patient, tell
them what you are doing and why you are
doing it.
Successful workplace violence prevention
programs empower healthcare workers
to come forward when incidents occur.
Healthcare workers must know and believe
that incident reports are taken seriously
by management. Those involved in the
incident should be included in the process
and receive feedback regarding the status of
the investigation and anticipated actions.
BY: ERIC P. WOKAS, CSP ARM
RISK CONTROL CONSULTANT
JGS INSURANCE
Eric Wokas has over 25 years of experience
as a risk management consultant working
for various major property/casualty
insurance carriers including Continental,
Zurich and Gerling as well as Aon an
international insurance brokerage firm.
At JGS Insurance Mr. Wokas continues
to assist clients in development and
implementation of practical solutions in
reducing risk.