Required Training Reported by Respondents
Staff practice with role delineation in active threat 12
Required on-line training 60
Personal safety or defense strategies Physical resistance or escape methods
Personal protection methods Intruder scenario
Active shooter Patient protection
12
13
19
20
19 41
Defining workplace violence 74
Stricherz , Kwatcher , Kretzner 2015
0 10 20 30 40 50 60 70 80 to de-escalate a situation by speaking calmly , and not arguing , threatening , challenging or shaming . “ Hey John , you seem pretty upset . What ’ s going on ?” or “ Tell me what happened ; I will try to help you .” And then listen with your full attention . We all may experience times when the frustration and stress seem to be overwhelming . Having someone to calmly listen and acknowledge our pain and frustration helps to diminish it ; we feel heard . If the person continues to escalate their behavior , you need to call for help ; make sure facility staff are aware if possible , have someone call 911 , or pull a fire alarm . In light of current events , it is important to have a discussion of what to do in the case of an active shooter in a dialysis facility . Conventional wisdom is to run , hide , or fight ; all of which may be difficult for a patient connected to a machine . This is the why everyone needs to be a part of prevention ; immediately reporting concerns , making sure security doors are not wedged open , or perhaps helping to de-escalate a situation . Based on our research , we have identified several risk factors at the organizational level :
1 . Lack of facility policies and staff training for recognizing and managing escalating hostile and assaultive behaviors . 2 . Working when understaffed . 3 . High staff turnover . 4 . Inadequate numbers of and inadequate training of security and mental health personnel in violence responses on site . The staff responding to our survey indicated they are generally not well prepared or supported , and are bound by limited training in preparation , response , and post-event response to violent acts . Only 3 % reported having on-site lawenforcement , and 23 % reported having security officers with responsibility for checking patients in . Training for personal responses or defensive strategies for safety are not generally available to employees and certainly not for patients . Generally , we found a lack of prevention plans for responding to threats of violence . Prevention and training require time and financial resources that do not contribute to clinical outcomes or profits . What will you need to do to feel safe ? We encourage you to develop your own protection plan and develop the responses you could or should do .
12