table below, ranging from threats, property damage, sexual
assault, to death.
74
76
71
39
41
19
17
13
9
5
20
3
8
There are three main risk factors for threats of violence in
dialysis centers: people suffering from mental illness, substance
22
25
42
7
Secondary
0
45
25
Primary
30
5
38
35
10
57
40
15
64
45
20
Report weapons used
20
% Respondents Indentifying Primary and Secondary
Coordinator’s of Response
Of all the incidents reported, 50% were carried out by patients,
largely in response to staff setting limits. Consider the types of
things that commonly occur:
• A patient is upset that they are not put on at the expected
time.
• A patient is offended by another patient’s behavior, dress,
politics, sexuality, etc.
• Staff does not respond to patient’s need in a timely
manner.
A variety of weapons used was also reported. Some were
used to do physical harm, others were used to threaten harm.
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types of violence reported
abuse, or an inability to cope with the changes presented
by life. These can afflict patients, staff, or family members.
Additionally, the characteristics of the neighborhood need to
be taken into consideration. Is there gang activity, shelters or
soup kitchens, or homeless people in the area?
Personal Safety:
There are things you can do to stay safe. It starts with being
aware. When you are coming to a facility for dialysis, you
are naturally thinking of your own care, your own day. But
a dialysis facility is no different from another public place.
You want to be aware of your surroundings; who is there,
what’s going on, where are the exits? Are exists blocked or
accessible? Is the security door to the treatment area propped
open? Is the parking area well lit? Do you know how to safely
disconnect from your machine in an emergency?
It would be a tremendous relief to believe that staff will
take care of any potentially violent situation, but staff have
varying levels of training, experience, and communication
skills. At certain times, there is only a “bare bones” staff. In
our research, we asked about the primary and secondary
coordinators of a response to violence. The most frequently
identified person was the dialysis facility manager, followed
by “no one.”
Further, staff may not have the training and practice to feel
they can respond competently. Sixty percent of respondents
reported they had on-line training, but fewer than half
reported any other kinds of training.
If you hear someone making threats or see an action that
tells you danger is present, report it immediately. A lot of
times people will say “I don’t want to get involved,” but
it is your involvement, and everyone else’s that create a
culture of safety by working together. You may be able
11