workplace violence prevention. © copyright 2006 ontario safety association for community &...

Workplace Violence Prevention

2© Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law.

• Defining Workplace Violence

• Forms and types of workplace violence

• Workplace violence injury statistics

• Prevalence and risk factors

• Developing a general Workplace Violence Prevention program

Overview


Definition

• “Any act of aggression that causes physical or emotional harm, including assault (any attempt to inflict physical harm on a worker), threat, verbal abuse, sexual harassment and racial or religious harassment” (OPSEU)

• “Attempted, threatened or actual conduct of a person that endangers the health and safety of the worker including any threatening statement, harassment or behaviour that gives a worker reasonable cause to believe that his/her safety is at risk (N.S. H&S Advisory Council)”


Health Care40%

Industrial12%

Forestry0%

Services10%

Transportation5%

Construction0% Education

9% Electrical0%

Farm3%

Municipal21%

Treatment Clinics & Specialized Services

8%

Professional Offices & Agencies

2%

Schedule 211%

Nursing Homes27%

Retirement Homes1%

Hospitals26%

Nursing Services3%

Group Homes22%

Ontario Health Care & Community Services

Data Source: WSIB Injury Analysis by SWASnapshot Period: July 2005

Workplace Violence/Client Aggression - 2004 LTI’s


Workplace Violence/Client Aggression - 2004 LTI’s

0

50

100

150

200

250

2000 2001 2002 2003 2004

Nursing Homes Retirement Homes Hospitals

Nursing Services Group Homes Treatment Clinics & Specialized Services

Professional Of f ices & Agencies Schedule 2

Data Source: WSIB Injury Analysis by SWASnapshot Period: July 2005


“Workplace violence is one of the most complex and dangerous occupational hazards facing nurses” (McPaul & Lipscomb, 2004)• Health and community care workers exposed to a variety of violent/aggressive individuals• Many still do not agree that the issue is real• Many consider violence “part of the job”• Many organizations do not have a strong violence prevention program • No protective regulations addressing workplace violence

Prevalence


• Many papers describing and explaining the issue of workplace violence however, few intervention studies exist (Arnetz & Arnetz, 2000)

• Assault rates for residential-care, nursing and personal-care workers more than ten times the rate than that of private non-health (Hewitt & Levin, 1997)

• British Columbia study suggested that health care workers face similar level of risk to that of police (Boyd 1995)

Prevalence


Traditional Approaches to Aggression Prevention

• Focus on methods to manage, contain or reduce the impact of the aggressive act

• Rely on physical methods to deal with the situation• Focus on body containment techniques – based on a

philosophy of care that focuses on pathologies which reinforces negative perceptions of persons with dementia as being assaultive, violent, dangerous and the passive recipients of care!

• Do not seek to understand the underlying reason for the responsive behaviors (Jones, 1999)

• Focus on containment and control of aggressive individuals (dictated care regimes, use of physical or chemical restraints)


• Not tailored for the learning needs of front-line staff in long-term care homes

• Are in direct contrast to the shift in culture that has occurred in dementia care in last decade - movement toward person - or relationship - centered care

• Have inappropriate response techniques that may have a pervasive and profound negative impact on residents with cognitive impairment, leading to excess disability and a wounded spirit (Taft, 1995; Dawson, Wells & Kline, 1993; Rader, 1995)

• Increase the risk of staff injury• Do not equip staff with the necessary knowledge and

point-of-care practices to decrease risk

Traditional Approaches to Aggression Prevention


• Threats of violence

• Verbal and emotional abuse

• Harassment based on sex, religion, sexual orientation, disability, race

• Use of, or threats to use force

• Inappropriate suggestions, inference, comments, or behavior

• Carrying a weapon

• Intimidation and aggressive behavior

• Domestic Violence

Forms


Type I (Criminal Intent): • Perpetrator has no relationship to the workplace

Type II (Client/Customer): • Perpetrator is a client who becomes violent towards a worker or

another client “Majority of threats and assaults against caregivers come from patients/families/visitors” (Arnetz & Arnetz, 2000)

Type III (Worker-to-worker): • Perpetrators are employees or past employees

Type IV (Personal Relationship): • Perpetrator usually has a relationship with an employee (e.g.

domestic violence in the workplace)

Types (Cal/OSHA 1995)


Environmental, Ergonomic & Administrative:• Crowded, noisy conditions • Overcrowded resident areas• Lack of staff education/training• Lack of security controls• Assigning staff to work alone, work in remote locations, and/or high crime areas• Understaffed areas• Lack of worker experience contributing to quality

issues

General Risk Factors


Client’s Physiological Conditions:• Systemic disorders: fluid/electrolyte imbalance,

anemia, thyroid disorders, diabetes, hepatic disorders, neurological disorders, epilepsy, degenerative diseases• Toxic levels of medications • Psychiatric Conditions: psychotic symptoms & paranoia, psychogeriatric illness• Substance Abusers

General Risk Factors


A Guide to the Development of a Workplace Violence Prevention

Program

Book one: Implementing the Program in Your Organization

Book two: Developing Crisis Prevention & Communication Strategies

Book three: Developing Human Resources Strategies for Managing Workplace Violence

Book four: Preventing Client Aggression Through Gentle

Persuasive Approaches™



Program

Book one: Implementing the Program in your Organization

Step 1• Secure management commitment

• Assess your program needs

• Develop program components

Step 2 and 3• Implement program

Step 4 and 5• Evaluate program


Management commitment is:

• The foundation of an effective program

• Necessary to ensure that other resources are available to develop, implement and maintain the program (budget, human resources, materials, equipment, training, etc.)

Step 1 Secure Management

Commitment


Initial tasks:

• Enlist senior management commitment to program

• Appoint a program leader

• Appoint a multidisciplinary steering committee

• Determine whether committee will be an ad hoc or standing committee

Step 1 Secure Management

Commitment


• Community workplace violence issues

• Internal documents:• Security, emergency response, unusual occurrence,

client abuse, EAP

• Employee incidents/accidents

• Physical environment

• Work setting and clients

• Point-of-care work practices

• Employee perceptions

Step 1 Assess Your Needs


Workplace Violence Documentation Analysis tool

Appendix D

Unit Workplace Violence Incident/Accident Analysis Collection tool

Appendix E

Organizational Workplace Violence Incident/Accident Summary tool

Appendix F

Environmental Assessment tool Appendix G-1

Community Workplace Assessment tool Appendix G-2

Step 1Assess Your Needs


Work Setting and Client Risk Factors Checklist

Appendix H

Checklist of Risk Factors for Aggressive Behaviour

Appendix I

Point-of-care Staff Work Practice Assessment

Appendix J

Workplace Violence Employee SurveyAppendix K

Appendices from OSACH“Guide to the Development of a Workplace Violence Prevention Program” and included in Participants’ Manual

Step 1Assess Your Needs


Step 1 Develop the Program

A comprehensive Workplace Violence Prevention program includes:

• Workplace violence prevention policy

• Associated procedures



Develop a Violence Prevention Policy that includes:• Employer commitment• Policy purpose and statement• Applicable definitions • Roles and responsibilities• Reporting and investigation • Risk assessment• Emergency response• Employee training• Program audit, review and revision



Violence Prevention Procedures include:• Reporting

• Emergency response

• Investigation

• Environmental and security controls

• Administrative controls

• Work practices

• Travel- Appendix S


Step 2 and 3Implement the Program

Critical steps:

• Ensure development of Workplace Violence Prevention policy and procedures

• Develop a communication and marketing plan

• Develop and present staff training

• Launch the program


Type of Training Attendees

Program Development Multidisciplinary committee/ steering committee

Security & Emergency Response Procedures

Emergency response team

Security personnel

General Workplace Violence Prevention Training

All staff

Job-Specific Training Unit/department specific staff

Step 2 and 3Implement the Program


Step 4 and 5Evaluate the Program

Goals of program evaluation:• Create and maintain a safe working environment without

the threat of violence • Review, revise, enhance and improve program

components based on:• program self-audit • results of qualitative and quantitative evaluation

procedures• Maintain the program• Continuously improve Workplace Violence Prevention

program


Book two: Developing Crisis Prevention and Communication Strategies• Staff training in crisis intervention• Recognizing and responding to stages of violence• Crisis response team• Effective communication skills• Environmental conditions during crisis interventions• Cultural sensitivity• Emergency response• Employee’s needs during and after crises


Program


Book three: Developing Human Resources Strategies for Managing Workplace Violence

• Prevention of violence among employees

• Harassment

• Domestic violence

• Threats

• Weapons

• Hiring and Termination practices


Program


Resources

The following OSACH Resource may be purchased from our website – http://www.osach.ca


Questions?

Concerns?

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workplace violence prevention. © copyright 2006 ontario safety association for community &...

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