Workplace Violence Prevention Plan: Practical Approaches | Joint Commission
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Workplace Violence Prevention Plan: Practical Approaches


Apr 25, 2017 | 2563 Views

By Ann Scott Blouin, RN, PhD, FACHE
Executive Vice President of Customer Relations
The Joint Commission

Incidents of workplace violence are increasing in many healthcare settings, but hospital workers are especially vulnerable to aggressive behaviors .

It stands to reason. After all, especially for nurses or physicians, we’re the ones sometimes delivering upsetting news to patients and families.
For nurses like myself, it’s a sad fact that violence has unfortunately become more common. In fact, many of The Joint Commission’s Office of Quality and Patient Safety staff are registered nurses and are all too familiar with the reality of a patient or family encounter gone awry. This often occurs in the emergency department or behavioral health, but violence is occurring in long term care, outpatient care and home care.

Personal Risk Factors
There are a number of steps that can be taken at the personal and organizational levels to minimize risk.

Women tend to be attacked more than men and these confrontations almost always happen when the victim is alone. Assaults in isolated locations such as the interventional radiology area are rooted in the fact that it’s an opportunity for the perpetrator to catch the victim solo.
The buddy system is a great offense, although it’s not always feasible to find an extra person to accompany you on trips to remote areas of the hospital. With this in mind, literature from organizations including the American Nurses Association, Emergency Nurses Association and American Organization of Nurse Executives reminds clinicians to use their instincts. If something doesn’t feel right, trust your gut, protect yourself and/or remove yourself from being alone in the situation.

De-Escalation Training
Whether you’re a nurse, physician, mental health technician, or security guard, and find yourself in a situation that could turn violent, the absolute most important thing you can do is de-escalate.
De-escalation has been proven to be even more successful than having armed guards at the hospital. Some studies report that armed security guards may add tension to an already hostile situation.  CMS considers weapons not to be acceptable as healthcare interventions, but rather law enforcement.

Many of us have no training in de-escalation techniques. Unless you’re a behavioral health staff member, de-escalation wasn’t usually covered in our undergraduate core curriculum.
It’s critical that de-escalation training is hardwired into your organization and introduced at new employee orientation. All staff, new and current, need to know how to defuse potentially violent situations.

Developing a Workplace Violence Prevention Plan
Our Joint Commission Workplace Violence Resource Center includes resources such as starting points for several prevention plans that you’re welcome to use. Steal shamelessly!?

As expected the first step to customizing your own plan is conducting a risk assessment. Many organizations skip this step but it’s really critical to know your:

  • Surveillance policies
  • Points of access
  • Security team’s emergency policy
  • Relationship with local police force

While these steps sound simplistic, they save lives. I can recall a hospital that experienced a tragedy because the security team didn’t know how to get to the location where the victim needed help.

Enforcing Zero Tolerance
Unfortunately, sometimes cases of workplace violence originate from conflict between employees. (It happens everywhere…)

If you already have a zero violence and bullying tolerance plan on the books, you’re a step ahead. Whether the policy’s been in place for years or just being announced, leadership support is essential for making it part of your culture, not just a paragraph in the employee handbook. Know that perpetrators are not always from the outside community.

Comprehensive incident reporting can lead to accurate root cause analysis and, eventually, solutions. Once you have established reporting systems that are easy and non-punitive, staff will know you’re truly concerned about their safety.  Increased incident reporting goes hand-in-hand with more effective prevention and better understanding of risk areas. Workplace Violence Prevention Month may be coming to a close; however our work continues to keep patients and staff safe from workplace violence.

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