workplace violence prevention 0421 - 1199c training · risk: the problem} workplace violence is a...
TRANSCRIPT
![Page 1: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/1.jpg)
Workplace Violence Prevention in Healthcare
District 1199C Training Fund HWWH SH-29634-SH6
![Page 2: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/2.jpg)
This material was produced under grant SH-29634-SH6 from the Occupational Safety and Health Administration, US Department of Labor. It does not necessarily reflect the views or policies of the US Department of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government.
District 1199C Training Fund HWWH SH-29634-SH6
![Page 3: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/3.jpg)
Preventing Workplace Violence in Healthcare: Learning Objectives
District 1199C Training Fund HWWH SH-29634-SH6
} What is Workplace Violence?} Who is Affected? Who Gets Hurt?} Risk Factors} Prevention and De-escalation} Recognize Warning Signs} What Employers Can Do} What Others are Doing} OSHA and Employee Rights
![Page 4: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/4.jpg)
What is Workplace Violence?} A range of hostile behavior in the workplace:} Verbal Abuse} Intimidation, harassment, or threatening behavior } spoken, written, or physical
} Working around people who try to insult or intimidate you} Being exposed to hostile behaviors that get in the way of
your ability to do your job
District 1199C Training Fund HWWH SH-29634-SH6
Verbal Abuse, Harassment,
Bullying
Intimidation, Threats
Physical Contact, Assault
Severe Injury Death
BAD à à à WORST
![Page 5: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/5.jpg)
What is Workplace Violence?
Psychological Intimidation/Harassment
Making statements that are:
• False (slander)• Malicious (mean) • Insulting • Name Calling• Rude, Disrespectful
• Bullying• Lying to hurt
someone’s reputation
5District 1199C Training Fund HWWH SH-
29634-SH6
![Page 6: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/6.jpg)
What is Workplace Violence?
Physical Intimidation/ Harassment
• Physically holding someone back
• Blocking movement• Impeding
• (Getting in their way, on purpose)
• Trapping, Cornering• Following
} Stalking} Inappropriate
contact/advances} Repeated unwelcome
touchingPPT-046-01 7
District 1199C Training Fund HWWH SH-29634-SH6
![Page 7: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/7.jpg)
What is Workplace Violence?}Assault – Intentionally causing physical injury, pain or distressØ Hitting, slapping, punching, pushing,
shoving, poking or kickingØ May include use of weapons, furniture.
PPT-046-01 8District 1199C Training Fund HWWH SH-
29634-SH6
![Page 8: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/8.jpg)
Risk: The Problem} Workplace violence is a serious concern for 15 million
healthcare workers in the US} 2013 – over 153,000 workers reported assault in
healthcare facilities} 25,000 of these cases were severe enough to result in missed
days of work (up 12% from 2011)} Psychiatric aides have
the highest rates of missed days of workdue to workplaceviolence injuries
} Workplace Violence Underreported: These numbers may actually be higher
District 1199C Training Fund HWWH SH-29634-SH6
http://democrats.edworkforce.house.gov/publication/additional-efforts-needed-help-protect-healthcare-workers-workplace-violence
![Page 9: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/9.jpg)
Risk: Who is affected?} About 2 million American workers are victims of
violence every year*} Can affect anyone} Some people are more at risk} Working alone or in small groups} Working late at night or in the early
morning} Working in high-crime areas} Lots of contact with the public} Working with long waits, over-crowding
• https://www.osha.gov/Publications/osha3148.pdf-
• Page 2
District 1199C Training Fund HWWH SH-29634-SH6
![Page 10: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/10.jpg)
Who is at greater risk?
} Social Services Workers} Behavioral Health Workers} Frontline Healthcare Workers} Nurses and Aides} Medical Professionals
District 1199C Training Fund HWWH SH-29634-SH6
![Page 11: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/11.jpg)
Who is at greater risk?} Those who care for patients can be at
risk during:Ø Communicating with FamilyØ Evaluating PatientsØ Emotional or PsychiatricØ Physical
Ø Meal timesØ Visiting HoursØ Patient TransportØ Patient CareØ Wound careØ Bathing
District 1199C Training Fund HWWH SH-29634-SH6
![Page 12: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/12.jpg)
Risk: Where Violence Happens
PPT-046-01 11
Ø Waiting Rooms, Emergency RoomsØ Labor and Delivery RoomsØ Around Family MembersØ Patient HomesØ Alzheimer's UnitsØ Drug Treatment or Group HomesØ Whenever working around alcohol or
illegal drugs
District 1199C Training Fund HWWH SH-29634-SH6
![Page 13: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/13.jpg)
Risk: Where Violence Happens
PPT-046-01 11
Ø Poorly lit areas (stairs, parking lots)Ø No buddy or check-in systemØ No security or alarm systemØ Poor CommunicationØ Isolated workplaceØ Workplace exposed to crowded public
areas
District 1199C Training Fund HWWH SH-29634-SH6
![Page 14: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/14.jpg)
Risk: Who Causes Violence?Anyone -} Patients} Patient’s family or friends} People you have worked with} Acquaintances} Random strangers
VIOLENCE CAN HAPPEN TO ANYONEregardless of age, race, ethnicity, religion, geography, ability, job title, appearance, sexual orientation, and gender identity.
District 1199C Training Fund HWWH SH-29634-SH6
![Page 15: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/15.jpg)
Risk: What Makes People Violent?} Sometimes people who experience TRAUMA
(whether emotional or physical) act out in an uncontrolled ways when:} They feel “triggered” by situations that remind them of
hard times, or } They get traumatized by feeling:} Sick, vulnerable} Afraid, terrified} Alone, helpless} Grief } Anger, rage} Despair, hopelessness} Physical pain
District 1199C Training Fund HWWH SH-29634-SH6
![Page 16: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/16.jpg)
Risk: What Makes People Violent?
} Intense Emotion, Frustration} Trauma } Mental or emotional illness
} Some people act with violence in order to control or dominate a situation
} Desperation: Having no other ‘tools’ to use
District 1199C Training Fund HWWH SH-29634-SH6
![Page 17: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/17.jpg)
Escalating Behavior• Physical Attack• Sexual Abuse• Domestic Violence• Murder
Violence
Threats
• Shouting, yelling• Slamming doors, drawers• Throwing things• Damaging property
Disruptiveness
• Impatience• Change in tone of voice and body language• Inappropriate remarks or offensive language
Frustration
District 1199C Training Fund HWWH SH-29634-SH6
• Verbal or written• Threatening or obscene phone calls• Not respecting ‘boundaries’ • Being followed, stalked
![Page 18: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/18.jpg)
De-escalation } De-escalation means To Calm Things Down
District 1199C Training Fund HWWH SH-29634-SH6
![Page 19: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/19.jpg)
De-Escalation Tips
DO DO NOTØ Show a calm, caring
attitudeØ Try to acknowledge
what the person is saying and feeling
Ø Assess each situation for safety
Ø Stay Alert!
} Do not match the attitude of someone who is angry or frustrated
} Do not isolate yourself} Do not let yourself get
penned in} Do not lose a clear
pathway to ESCAPE
District 1199C Training Fund HWWH SH-29634-SH6
![Page 20: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/20.jpg)
Interpreting BehaviorPeople express themselves in many different ways.
} Get training on cultural differences} Uncomfortable with someone’s behavior?} Ask them to behave differently:“You are talking really fast.I am having a hard time understanding you. Could you please slow down?”
}Difference is not danger
District 1199C Training Fund HWWH SH-29634-SH6
![Page 21: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/21.jpg)
Prevention: Personal Boundaries
} Respect Personal Space} Keep about 1½ to 3 feet of space between you and other
people} Do not touch the person OR their belongings –
Especially if someone is upset or angry
District 1199C Training Fund HWWH SH-29634-SH6
![Page 22: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/22.jpg)
Recognize Upset or Frustrated Behavior} Change in the person’s tone of voice } Change in the person’s body language} Impatient behavior} Changes in how YOU FEEL when talking to them
NOTE: Just because someone is displaying these actions does not necessarily mean they will become violent.
District 1199C Training Fund HWWH SH-29634-SH6
![Page 23: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/23.jpg)
Compassionate Listening} When someone is frustrated -
Put yourself in their shoes} Think about what they are going through} A husband just found out his wife has cancer} A family cannot pay their medical bills} A sick patient feels they are not being given decent care
from the nurses/doctors
} Think about how you might feel in the same situation (frustrated, scared, angry, etc.)
} Consider how you would want to be treated in the same situation
} Think BEFORE you respond
District 1199C Training Fund HWWH SH-29634-SH6
![Page 24: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/24.jpg)
De-escalation Techniques } When someone is frustrated:} LISTEN with respect} Speak with a soft voice} Re-state what the person said so they know you heard them} Try to help them, if you can} If you cannot help them, give them other options to find what they
need
} Apologize, if necessary} Tell people what to expect and be honest
Set limits on their behavior} “It’s not necessary to shout, I hear your concerns.”
District 1199C Training Fund HWWH SH-29634-SH6
![Page 25: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/25.jpg)
Helpful Suggestions} Pay attention to your voice tone and
volume – your “energy”} Mirroring: Behave with the behavior you
want them to show you
} Use ‘open’ body language} Don’t cross arms, legs} Stay relaxed} Take a deep breath &
calm yourself down
} Try not to take their emotions or problems personally
District 1199C Training Fund HWWH SH-29634-SH6
![Page 26: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/26.jpg)
Recognize Disruptive Behavior} Rude language} Yelling, shouting} Pointing and jabbing fingers;
pounding fists } May come closer to you than
you are comfortable with
NOTE: Just because someone is displaying these actions does not necessarily mean they will become violent.
However, this behavior is inappropriate and disruptive -It is not OK.
District 1199C Training Fund HWWH SH-29634-SH6
![Page 27: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/27.jpg)
De-escalation Techniques} When someone is disruptive:} Keep yourself calm} Take a deep breath…..
} Choose your words carefully} Give clear instructions } Set respectful, firm boundaries
} If you can’t lower your voice,you will have to come back at another time when you can speak more calmly.} Please control yourself and sit down. Otherwise,
I will have to call security
District 1199C Training Fund HWWH SH-29634-SH6
![Page 28: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/28.jpg)
De-escalation Techniques} Set boundaries by giving clear instructions} For example: } Please do not use profanity or curse} Please speak more quietly} If you continue to interrupt me I will not be able to help you} Please sit down
} Make sure YOU have a direct escape route to safety in case things get out of control
} Signal for help if you feel uncomfortable or threatened
District 1199C Training Fund HWWH SH-29634-SH6
![Page 29: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/29.jpg)
Recognize Threatening Behavior} Actual written or verbal threats} Person invades your personal space
in a way that makes you feel threatened or intimidated
} Person does not respect the boundaries you or someone else has set
District 1199C Training Fund HWWH SH-29634-SH6
![Page 30: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/30.jpg)
Recognize Threatening Behavior} Person follows, stalks, phones or
emails you in inappropriate ways} You feel scared because of:} What they said} How they behaved
} You are afraid for your physical safety} Being threatened with any kind of harm,
revenge, a weapon or violence} YOU might feel angry in response
District 1199C Training Fund HWWH SH-29634-SH6
![Page 31: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/31.jpg)
Recognize When Someone Might Become Violent
} Loss of emotional control} Body language} Throwing things} Invasion of personal space} Inappropriate touch} Shoving, pushing} Weapons} History of violent behavior
District 1199C Training Fund HWWH SH-29634-SH6
![Page 32: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/32.jpg)
Activityhttps://youtu.be/aHllPBt868E
1. Can you identify any hazards in the parking garage?2. Do you think Marks’s colleagues should have tried to talk to
him about how he’s been acting?3. Who is the “victim” here, Mark or his colleagues? 4. Should the supervisor have done anything before talking to
Mark in her office?5. Do you think the supervisor handled the conversation in a
good way? If so, why or why not?6. What could she have done differently?7. Can you identify any hazards in the supervisor’s office?8. What kind of programs or procedures could have been in
place to prevent the situation from reaching this point?District 1199C Training Fund HWWH SH-
29634-SH6
![Page 33: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/33.jpg)
Safety and De-escalation Techniques
}YOUR SAFETY COMES FIRSTIf you think someone will become violent:} GET AWAY AND GET OUT!} CLEAR ESCAPE ROUTE} SAFE SHELTER
} Call for Help – Security – Police - 911} DO NOT confront the person} DO NOT try to stop the person yourself
District 1199C Training Fund HWWH SH-29634-SH6
![Page 34: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/34.jpg)
Reporting and Documentation
}Report all incidences of inappropriate touch, workplace violence or intimidation} Keep a record of everything you report} Prevent the same thing from happening to
someone else
District 1199C Training Fund HWWH SH-29634-SH6
![Page 35: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/35.jpg)
Which situation is safer for the nurse?} When in a room with a patient, place yourself so that you
can easily escape when possible
District 1199C Training Fund HWWH SH-29634-SH6
EXIT
EXIT
NURSE
NURSE
VISITOR
VISITOR
Note: If at any time patient or visitor behavior begins to escalate, make sure you have a clear exit plan.
![Page 36: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/36.jpg)
Clothing Safety} Keep it Simple: Do not let your clothing
or accessories get used against you
District 1199C Training Fund HWWH SH-29634-SH6
![Page 37: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/37.jpg)
ZERO TOLERANCE} ZERO TOLERANCE
for inappropriate touch} ZERO TOLERANCE
for threats or violence of any kind
District 1199C Training Fund HWWH SH-29634-SH6
![Page 38: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/38.jpg)
Staying SafeYOUR safety is your top priority:
} Document & report any behavior that is:} Inappropriate} Threatening or Intimidating} Violent
} Keep copies of anything (everything) you report
District 1199C Training Fund HWWH SH-29634-SH6
![Page 39: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/39.jpg)
Staying SafeLearn from ‘Close Calls’ } Hazardous incidents that almost happened} Came close} Just missed you} Dangerous but you escaped harm
} Take Close Calls seriously} Management should investigate and analyze Close Calls} What you learn will help keep other workers safe
District 1199C Training Fund HWWH SH-29634-SH6
![Page 40: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/40.jpg)
Staying Safe – Review } Recognize Early Signs of ESCALATING BEHAVIOR} Frustration, Upset, Disruption or Violence
} Try to de-escalate before it gets out of control} Calm things down
} Set clear boundaries with clear and realistic consequences
} Get HELP if you feel threatened or intimidated} Know your EXIT ROUTE} Report and document what happened
YOUR SAFETY COMES FIRST
District 1199C Training Fund HWWH SH-29634-SH6
![Page 41: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/41.jpg)
What can your employer do?
}Make it clear to ALL employees, visitors and patients that the facility has a Zero Tolerance Policy for workplace violence
District 1199C Training Fund HWWH SH-29634-SH6
![Page 42: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/42.jpg)
What can your employer do?} Create Incident Reporting System} Threats, intimidation or harassment} Inappropriate touch} Violence} Close calls
} Create Incident Investigation Team } Explore Lessons Learned
District 1199C Training Fund HWWH SH-29634-SH6
![Page 43: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/43.jpg)
What can your employer do?Provide:} Signs} HOW to get help} ‘Area Under Surveillance’
} Free medical care as needed} Workers Compensation
} Free, confidential counseling services for victims and witnesses of workplace violence
} Let employees know that no one will be punished in any way for reporting workplace harassment, intimidation or violence
District 1199C Training Fund HWWH SH-29634-SH6
![Page 44: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/44.jpg)
What can your employer do?
} Write Violence Prevention Policy} Write effective Violence Prevention
Procedures, including Zero Tolerance Policy
} Provide Violence Prevention Training for all employees} Set up a Violence Prevention Committee
District 1199C Training Fund HWWH SH-29634-SH6
![Page 45: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/45.jpg)
Violence Prevention Committee} Include workers with
direct patient contact} Include supervisors} Include Union
members & reps} Meet regularly} Review policies and
procedures to make sure they work well
} Investigate Incidents & Close Calls} Where, Why, How,
Who?} How could incident
have been prevented?} Walk-through the facility
to identify RISK} “Risk Assessment”
} Document challenges and successes
District 1199C Training Fund HWWH SH-29634-SH6
![Page 46: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/46.jpg)
Violence Prevention Committee} Committee Makes Recommendations
based on incident investigations and facility walk-throughs:} Alarms and Signal Systems} Security devices (cameras)} Additional security staff} Better or more lighting
District 1199C Training Fund HWWH SH-29634-SH6
![Page 47: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/47.jpg)
Violence Prevention Committee}Recommendations} Enclosed reception areas} Emergency Response Plans} Safe Shelter} “Shelter in Place”
} Clear Exit Pathways} No one works alone} Buddy System
} Security escorts if needed} Restricted Area Access} So public cannot reach workers without an escort} ID badges
District 1199C Training Fund HWWH SH-29634-SH6
![Page 48: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/48.jpg)
Violence Prevention Programs Work} 4 out of 5 studies on violence programs suggest that
violence prevention programs can reduce the rate or severity of assaults
} California – the rate of assaults dropped in emergency rooms after the state adopted a law requiring hospitals to develop violence prevention programs
District 1199C Training Fund HWWH SH-29634-SH6
http://democrats.edworkforce.house.gov/publication/additional-efforts-needed-help-protect-healthcare-workers-workplace-violence
![Page 49: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/49.jpg)
Active Shooter Situation} What should you do if someone comes into your
workplace/school with a gun and begins actively shooting?
District 1199C Training Fund HWWH SH-29634-SH6
![Page 50: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/50.jpg)
Run. Hide. Fight. Surviving an Active Shooter Eventhttps://vimeo.com/73940709
District 1199C Training Fund HWWH SH-29634-SH6
![Page 51: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/51.jpg)
Follow Up Questions} Did anything surprise you in this video about what you
should/should not do?} What do you think might have prevented this situation?} Have your thoughts/feelings changed about what you
should do in an active shooter situation?
District 1199C Training Fund HWWH SH-29634-SH6
![Page 52: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/52.jpg)
What others are doing –New Jersey Law} NJ Law (Chapter 326, State of NJ 2011)} Requires hospitals, psychiatric hospitals & nursing homes to
establish violence prevention programs} Each facility must establish a violence prevention program} Violence prevention committee} Detailed, written violence prevention plan
} Yearly violence risk assessment/ plant inspection
$5,000 fine per violation that results in injury, $2,500 fine per violation that does not result in injury
*ten other states have laws to protect healthcare workers form workplace violence
District 1199C Training Fund HWWH SH-29634-SH6
![Page 53: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/53.jpg)
What others are doing –Philadelphia Teaching Hospitals} Clear reporting and response systems} Training} Online Violence Prevention training through computerized
training system } Individual department trainings} Small group presentations} Identify and address potential hazards} Review safe hiding places} Self defense techniques
} Active shooter drills} Emergency evacuation and response drills
District 1199C Training Fund HWWH SH-29634-SH6
![Page 54: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/54.jpg)
Federal EEOC Law} Equal Employment
Opportunity Commission (EEOC) – Title VII
} Worker are protected from harassment based on a legally protected class
} Acts done must be "severe or pervasive enough to create a work environment that a reasonable personwould consider intimidating, hostile, or abusive."
Protected classes: } Age - over 40} Disability, including
pregnancy} genetic information} national origin} race/color} Religion} Gender or Sex
District 1199C Training Fund HWWH SH-29634-SH6
![Page 55: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/55.jpg)
Federal OSHA Law} OSHA General Duty Clause:} Public Law 91-596 Section 5 (a) (1)} Each employer must furnish to each of his/her employees
employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his/her employee's.”
FREE FROM RECOGNIZED HAZARDS WHICH COULD CAUSE
PHYSICAL HARM
District 1199C Training Fund HWWH SH-29634-SH6
![Page 56: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/56.jpg)
Preventing Workplace Violence in Healthcare: Learning Review
District 1199C Training Fund HWWH SH-29634-SH6
} What is Workplace Violence?} Who is Affected? Who Gets Hurt?} Risk Factors} Prevention and De-escalation} Recognize Warning Signs} What Employers Can Do} What Others are Doing} OSHA and Employee Rights
![Page 57: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/57.jpg)
References} Guidelines for Preventing Workplace Violence for Health
Care and Social Service Workers (OSHA-3148), (2015)} https://www.osha.gov/Publications/osha3148.pdf
} CDC/NIOSH Workplace Violence} http://www.cdc.gov/niosh/topics/violence/} Free on-line course about workplace violence prevention for
Nurses:http://www.cdc.gov/niosh/topics/violence/
District 1199C Training Fund HWWH SH-29634-SH6
![Page 58: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/58.jpg)
Helpful Links for More Information} CDC Workplace Violence Prevention Course for Nurses} http://www.cdc.gov/niosh/topics/violence/training_nurses.html
} New Jersey Violence Prevention in Health Care Facilities Law} ftp://www.njleg.state.nj.us/20062007/PL07/236_.PDF
} OSHA resources} https://www.osha.gov/SLTC/workplaceviolence/evaluation.html
} Workplace Violence in Healthcare: Strategies for Advocacy by AnnMarie Papa, DNP, RN, CEN, NE-BC, FARN, and Jeanne Vanella, DNP, MS, RN, CEN, CPEN} OJIN: Online Journal of Issues in Nursing, Volume 18, No.1, Manuscript 5; Jan. 31, 2013
District 1199C Training Fund HWWH SH-29634-SH6
![Page 59: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/59.jpg)
Employee Rights Under OSHA
District 1199C Training Fund HWWH SH-29634-SH6
} Rights of Every Employee
![Page 60: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/60.jpg)
OSHA Rights and Whistleblower Protections
OSHA laws give workers the right to: } Participate in safety and health activities } Report work related injuries or illnesses } Report safety violations
District 1199C Training Fund HWWH SH-29634-SH6
Employer cannot take action against you for using your OSHA rights.
![Page 61: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/61.jpg)
Retaliation is Against the Law
District 1199C Training Fund HWWH SH-29634-SH6
} Firing or laying off
} Blacklisting
} Demoting
} Denying overtime or promotion
} Denial of benefits
} Disciplining
} Failure to hire or rehire
} Intimidation
} Making threats
} Reassignment affecting prospects for promotion
} Reducing pay or hours
NO
No ‘Adverse Actions’ for Safety Activities
![Page 62: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/62.jpg)
What if you get in trouble for complaining?Whistleblower Time Line
} OSHA LAWUnder Section 11(c) of the OSH Act, employees are protected from retaliation when they:} file a safety complaint} participate in a safety
inspection.
} TO BE PROTECTEDIf employees experience retaliation, they must file a complaint with
OSHA within 30 days.
} If employees win a complaint case, they could be entitled to back pay and compensation for damages
} If employees lose a complaint case, they have
15 days to “appeal” the decision.
} Second chance to win your case
District 1199C Training Fund HWWH SH-29634-SH6
![Page 63: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/63.jpg)
FIVE Ways to Communicate with OSHA
1. E-mail an Interactive ONLINE Form
2. Call OSHA3. In-Person Visit4. Fax a Complaint5. Mail a Letter
District 1199C Training Fund HWWH SH-29634-SH6
![Page 64: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/64.jpg)
How to contact OSHA} www.OSHA.gov} US Department of Labor/OSHA
Wanamaker Building100 Penn Sq East, 12th FloorPhiladelphia, PA 19107
Telephone: (215) 597-4955} Fax: (215) 597-1956} Toll-free number: 1-800-321-OSHA (6742)OSHA WILL KEEP YOUR INFORMATION CONFIDENTIAL
District 1199C Training Fund HWWH SH-29634-SH6
![Page 65: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/65.jpg)
For more informationHealthcare Occupational Safety CenterHealth Workers Working Healthy Training ProjectDistrict 1199C Training & Upgrading Fund100 South Broad Street, 10 FloorPhiladelphia, PA 19119www.1199ctraining.org
QUESTIONS?District 1199C Training Fund HWWH SH-
29634-SH6
![Page 66: Workplace Violence Prevention 0421 - 1199C Training · Risk: The Problem} Workplace violence is a serious concern for 15 million healthcare workers in the US} 2013 – over 153,000](https://reader033.vdocuments.net/reader033/viewer/2022060418/5f15e52fd122562338723192/html5/thumbnails/66.jpg)
With thanks to:
• Jefferson School of Population Health• Jefferson University Hospitals
• Department of Public Safety
• CDC Workplace Violence Prevention for Nurses• Health Workers Working Healthy
• Technical Advisory Committee
• Google Images
District 1199C Training Fund HWWH SH-29634-SH6