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DiversityNursing Blog

Hospital Workplace Violence: Precautions and Preparedness Techniques

Posted by Diversity Nursing

Fri, Feb 16, 2024 @ 09:07 AM

Workplace violence is a serious growing concern. Hospitals must prioritize precautions and preparedness measures to mitigate the risk of violence against staff, patients, and visitors.

According to a report  from National Nurses United, 81.6% of Nurses reported they have experienced workplace violence, with half stating they have seen instances of violence increase in the last year. 

"As a result, Nurses are subjected to multiple impacts of workplace violence, including physical and mental injury," the report summary states. "Injuries, including both physical and non-physical, can result in long-term physical and mental harm, resulting in RNs requiring medical care, taking time off work, and/or considering leaving their jobs or profession altogether." 

In total, 60% of Nurses say workplace violence has led them to change jobs, leave jobs or at least consider leaving the job or even the profession entirely, according to the report. 

Specifically, Nurses reported the following experiences to NNU: 

  • Verbally threatened 67.8%
  • Physically threatened 38.7%
  • Pinched or scratched 37.3%
  • Slapped, punched, or kicked 36.2%
  • Objects thrown at you 34.6%
  • Verbally harassed based on your sex or appearance 33.3%
  • Spat on or exposed to other bodily fluids 29.9%
  • Groped or touched inappropriate 19.8%

Around 18% noted they have not experienced workplace violence at all.

Here are several strategies hospitals are implementing to address workplace violence:

Policy Development 

Create explicit guidelines and protocols to prevent and address incidents of workplace violence. These policies should clearly state a strong stance against violence, provide mechanisms for reporting, and establish repercussions for those responsible.

Training and Education 

Ensure all staff members receive extensive training on identifying potential warning signs of violence, mastering de-escalation techniques, and effectively responding to emergency situations. It is crucial to conduct regular refresher courses to keep everyone up-to-date and well-prepared.

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Risk Assessment 

Perform comprehensive risk assessments to identify areas of susceptibility within the hospital, including emergency departments, psychiatric units, and waiting rooms. Implement focused interventions in areas with higher risk levels.

Physical Security Measures 

Enhance the overall physical security of the facility by implementing advanced security measures, including installation of state-of-the-art security cameras, panic buttons, access control systems, and ensuring optimal lighting conditions. Restrict access to sensitive areas and establish robust visitor screening protocols to further fortify the security of the premises.

Staffing and Staff Support 

To prevent overwork and fatigue, which can exacerbate tense situations, it is essential to maintain adequate staffing levels. Offering support services such as counseling and employee assistance programs can greatly assist staff in managing stress and trauma effectively.

Personal Protective Equipment (PPE) 

Provide staff with the necessary personal protective equipment (PPE) to ensure their safety in potentially volatile situations. This includes equipping them with duress alarms or protective gear, allowing them to feel secure and protected.

De-escalation Techniques 

Train all staff in effective de-escalation techniques to diffuse tense situations before they have a chance to escalate into acts of violence. Encourage staff to employ the power of verbal communication and non-confrontational body language to soothe and calm individuals who may be feeling agitated.

Collaboration with Law Enforcement 

Establish partnerships with local law enforcement agencies to enhance security measures and coordinate responses to violent incidents. If you don’t have any security staff at your place of work, consider hiring your own security staff or hire them from a security firm.

Incident Reporting and Investigation 

Promote a culture of prompt incident reporting and thorough investigations to gain insight into the underlying causes of violence. Utilize incident data as a valuable resource to shape effective prevention strategies.

Emergency Preparedness 

Establish comprehensive emergency response plans that clearly outline protocols for safely evacuating both staff and patients in the event of violent incidents. Regularly conduct drills and simulations to assess the efficacy and readiness of these plans, ensuring all personnel are well-prepared to handle any potential emergency situations.

Post-Incident Support 

Extend support and provide a wide range of resources to staff, patients, and visitors who have been impacted by workplace violence. Make available professional counseling services, essential medical care, and follow-up assistance fit for their individual needs.

By implementing these precautions and preparedness measures, hospitals can begin to create safer environments for their staff, patients, and visitors while effectively managing the risk of workplace violence.

Topics: safety, safety gear, workplace violence, nurse safety, violence in the workplace, workplace violence prevention, workplace violence prevention program, safety culture

Firework Safety Tips [INFOGRAPHIC]

Posted by Erica Bettencourt

Mon, Jun 29, 2015 @ 04:19 PM

Planning on celebrating the July 4th holidays with fireworks? Follow these tips and you’ll be fine. Please share with your friends and co-workers.

Untitled Infographic 2 resized 600

Topics: safety, infographic, fireworks, july 4th, dangerous

Time to Prove Hospital Disinfectants Work, FDA Says

Posted by Erica Bettencourt

Tue, May 05, 2015 @ 12:21 PM

BY MAGGIE FOX

www.nbcnews.com 

nc handwashin 140130 d2a038564c98deb8fe0d0a9589bd78b7.nbcnews fp 1440 600 resized 600Hospital workers wash their hands hundreds of times a day. Nurses are constantly using alcohol gels, chemical wipes and iodine washes on themselves and on patients.

Now that there's a hand sanitizer dispenser at every hospital room door, it's time to check that they actually do work as well as everyone assumes and that they are safe, the Food and Drug Administration says.

Up until now, FDA's just accepted that these products work as intended and are safe. But now, FDA says, there are tests available to actually prove they do. And because of the emphasis on hospital infections, institutions are using the products far more frequently than even 10 years ago and in many different ways.

So FDA issued a proposed plan Thursday for reclassifying some of the products, and for requiring makers to show they are safe and effective.

"We're not asking for any of these products to come off the market at this time."

In the meantime. FDA says, there's nothing for consumers to worry about and hospitals should continue using the products as they have been.

"What it seems they are doing is good due diligence," says Dr. Susan Dolan of Children's Hospital Colorado and the Association of Professionals in Infection Control.

"They are trying to look at the products, look at how they are being used today, how things have changed," she added.

The FDA proposes new rules making companies submit new studies looking at safety issues such as whether heavy, chronic use of the some of the products may cause them to soak in through the skin, or cause resistant bacteria to evolve.

Products that are not shown to be safe and effective by 2018 would have to be reformulated or taken off the market.

"We're not asking for any of these products to come off the market at this time. We're just asking for additional data," Theresa Michele, a director in FDA's drug center, said in an interview with The Associated Press. "And we're likewise not suggesting that people stop using these products."

Alcohol, iodine benzalkonium chloride and other germ-killers have been used for decades. But not to the degree that they are now.

"Twenty years ago you didn't find people using antiseptic gels 100 times a day. It just didn't happen," Michele said.

FDA points to studies that show some of the products might be absorbed into the body at higher levels than previously thought, showing up in blood and urine. Dolan says not all the studies show this, but it's worthwhile doing more checks.

"It's timely and it makes sense," Dolan said. "I do think consumers should not be worried. These are very effective products."

The FDA last updated its review of health care hand cleaners in 1994.

"They are trying to look at the products, look at how they are being used today, how things have changed."

"We emphasize that our proposal for more safety and effectiveness data for health care antiseptic active ingredients does not mean that we believe that health care antiseptic products containing these ingredients are ineffective or unsafe, or that their use should be discontinued," FDA said in its announcement.

The agency agreed to complete its review after a three-year legal battle with the Natural Resources Defense Council, an environmental group that accused the FDA of delaying action on potentially dangerous chemicals. In 2013 the FDA agreed to a legal settlement that included timetables for completing the review of various chemicals, including health care cleaners.

Environmentalists are mainly concerned about an ingredient called triclosan, which is used in most antibacterial soaps marketed to consumers. The agency issued a separate review of triclosan-containing consumer products in late 2013, saying more data are needed to establish their safety and effectiveness.


Topics: FDA, health, safety, nurses, doctors, medical, patients, hospitals, hand sanitizer, disinfectants

Skydiver has Seizure 9,000 Feet Up [VIDEO]

Posted by Erica Bettencourt

Wed, Mar 04, 2015 @ 03:12 PM

Bailey Johnson 

Some people like skydiving. Good for them. Some of us would prefer to stay on the ground where it's safe. But, you know, this video is sort of comforting in a way, because it shows that skydiving instructors are well-trained and know how to respond in a crisis. In another way, of course, this video is ABSOLUTELY TERRIFYING.

The video description has it all: "Possibly the scariest moment of my life. On the 14th of November 2014 while doing stage five of my Accelerated Free Fall program I have a near death experience. At around 9000ft I have a seizure while attempting a left hand turn. I then spend the next 30 seconds in free fall unconscious. Thankfully my jumpmaster manages to pull my ripcord at around 4000ft. I become conscious at 3000 ft and land safely back to the ground."

Yeah, we'll be staying on the ground, thanks.

Source: http://whatstrending.com

Topics: seizure, health, safety, video, sky diving, crisis

For Pregnant Marathoners, Two Endurance Tests

Posted by Erica Bettencourt

Mon, Oct 27, 2014 @ 02:35 PM

By 

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When Paula Radcliffe won the New York City Marathon in 2007, nine months after giving birth to a daughter, Isla, Radcliffe was considered an anomaly. Her intense training through her pregnancy, which included twice-a-day sessions and grueling hill workouts, was scrutinized and criticized.

Seven years later, maintaining a top running career and a family has become relatively common. About a third of the women in the professional field of 31 for the New York City Marathon next Sunday have children.

“I watched Paula win New York, basically leading from the starting gun to the finish tape, and afterward she picked up her baby,” said Kara Goucher, a top American marathoner. “I realized I can do both. And I want to do both.”

Goucher, 36, finished third in the 2008 New York City Marathon, and this year she will run the New York race for the first time with her 4-year-old son, Colt, cheering her on.

When she contemplated having a child, Goucher engaged in the careful strategizing common to elite female athletes, who consider precisely when to become pregnant so as not to risk missing out on an Olympic medal or sacrificing a corporate sponsorship.

Elite female distance runners now run competitive times well into their late 30s. The average age of a top female marathoner is 30, and 19 women in next Sunday’s professional field are that age or older.

As athletic peaks for these top runners have overtaken fertility peaks, the decision to combine motherhood and training has become increasingly unavoidable. Competitive careers are stretching: The American Deena Kastor, expected to be another top finisher next Sunday, is 41.

“I always wanted to have a child,” Goucher said, “and I didn’t want to wait until I was done, because I don’t really see an end date on my career. I wanted more in my life than just running. But the details of how you do that can get incredibly complicated.”

Elite runners often try to squeeze in a pregnancy and recovery in the 16-month window between world track championships in years with no Summer Olympics. This is one such year, and pregnancies abound.

Maternity leave in professional running is rare. A pregnancy is still frequently treated as if it were an injury, and women can experience a pay cut or not be paid at all if they do not compete for six months. During that period, they often remain bound to sponsors in exclusive contracts that can last upward of six years. Because the athletes are independent contractors, they are not covered by laws that protect employed women in pregnancy.

Lauren Fleshman, an N.C.A.A. 5,000-meter champion and a professional runner, switched to a women’s-oriented sponsor, the running apparel company Oiselle, before having a son in June 2013.

Referring to Goucher and Radcliffe, Fleshman said: “Kara and Paula showed that pregnancy doesn’t necessarily need to be an impediment to the athletic part of our careers, and blew up the vestiges of the myth of the ‘fragile woman’ who can’t be both a top athlete and a mother. But in terms of your career, there’s still the feeling that if you say you want to have a kid, you’re saying you don’t want to be an athlete.”

It does not help that so many people seem to have an opinion on the matter. After Alysia Montaño, a 2012 Olympian, ran an 800-meter race in June during her eighth month of pregnancy, her decision became the subject of intense public scrutiny.

“I wanted to help clear up the stigma around women exercising during pregnancy, which baffled me,” Montaño said. “People sometimes act like being pregnant is a nine-month death sentence, like you should lie in bed all day. I wanted to be an example for women starting a family while continuing a career, whatever that might be. I was still surprised by how many people paid attention.”

Montaño’s daughter was born in August.

“Giving birth is a very athletic activity, like going through intervals on the track,” Montaño said. “Like contractions, intervals can start out easy and progress as they get harder. There’s sometimes a point where you wonder, ‘Can I do one more set?’ But you know you’re going to make it. And then you kick to the finish.”

Other women have chosen different paths.

Clara Horowitz Peterson, a former top runner at Duke, focused on starting a family in her mid-20s, aiming for a racing peak afterward. Now 30, she is pregnant with her fourth child.

“I think if I’d chosen to train at altitude and log 120-mile weeks, I could have made it to the Olympics,” said Peterson, who typically runs 80 to 90 miles a week when not pregnant. “But that comes with sacrifices; you put your career first, and before you know it, you’re 28, maybe confronting fertility issues. I always felt like having children was more important to me than a running career.”

Still, Peterson ran right up until the births of her first three children. She qualified for the 2012 United States Olympic marathon trials just four months after delivering her second child, and she logged a 2-hour-35-minute time at the race four months later.

“I trained hard through that pregnancy,” Peterson said. “You can tell when you’re pushing it. You get twingy, or feel tendons pulling, so I backed off when that happened.”

To bounce back for the trials, Peterson said, she breast-fed her second child for only five weeks — finding that the hormones related to breast-feeding made her feel sluggish — and dropped the 20 pounds she typically gained during pregnancy in eight weeks without dieting. (She breast-fed her third child for six months.)

The understanding of women’s physical resilience during and after pregnancy has also developed in recent years.

“We still don’t have good science to guide us,” said Dr. Aaron Baggish, associate director of the cardiovascular performance program at Massachusetts General Hospital in Boston, which counsels elite athletes through pregnancy. “But unequivocally I think women should exercise through pregnancy, both for their baby and their own health. The body has evolved that way. Your baseline fitness level is the best guideline: Elite athletes start out with a higher threshold, so they can do more.”

After athletes give birth, efforts to get back into shape are consuming, coupled with the usual adjustments to caring for an infant. Breast-feeding interrupts the sleep that heals spent muscles and restores energy to a tired body. Babies are often kept out of group day care to prevent them from bringing home illnesses that could compromise rigid training plans.

Pregnancy can be hard to combine with any job. As in other fields, partners are generally a key component of elite athletes’ ability to continue their careers after having children.

Edna Kiplagat, a 35-year-old Kenyan who is among the favorites in next Sunday’s race, had two children before becoming a two-time marathon world champion and the 2010 winner in New York.

Her husband and coach, Gilbert Koech, gave up his running career to focus on hers and manage their family, making breakfast for their five children, three of whom are adopted, and taking them to school while Kiplagat trains.

Goucher’s husband, Adam, retired from professional racing a year after their son’s birth and started a running-related business. He tries to balance supporting her racing career with managing his new one, saying that he and Kara work to share equally in caring for Colt.

“Kara’s putting her body through a lot right now,” her husband said, “and we need to do everything possible to alleviate the stress of training. When she needs to go out and run, or needs to rest and recover, that’s my first priority.”

Goucher said she was taking the trade-offs in stride.

“It’s scary because the fact is for all women when you have a child, you do need to drop out for a long time, and you don’t know how you’ll come back,” she said. “It’s a huge risk. Of course, I’m serious about my job, but in life I needed to be more than that. So I think it was worth it.”

Source: www.nytimes.com

Topics: health, healthcare, training, baby, family, pregnant, running, safety, pregnancy, marathons

How Forensic Nurses Help Assault Survivors

Posted by Erica Bettencourt

Wed, Aug 13, 2014 @ 11:32 AM

By Lisa Esposito

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When forensic nurse examiners work with survivors of violence – sexual assault, child abuse, elder abuse or domestic assault – they’re painstakingly collecting and documenting evidence that can hold up in a potential court case. And they’re taking care of a person who’s just been traumatized, often by someone they know well. Forensic nursing takes a balance of objectivity, skill and compassion, and it’s more than just a job for the professionals who do it.

Experts on the Stand

Whatever type of assault they’ve endured, survivors’ first encounter with law enforcement or medicine “paves the way for their entire future,” says Trisha Sheridan, a forensic nurse and clinical assistant professor at Texas A&M Health Science Center College of Nursing.

Victims face a higher risk of post-traumatic stress disorder, depression, suicide and medical problems in the aftermath, she says, and those who “have a positive experience with someone who’s trained to deal with victims of violence” tend to not only have better legal outcomes, but better quality of life than others who receive standard emergency care. But in Texas, especially the more rural areas, forensic nurse examiners are few and far between.

Last year, Texas passed a law requiring emergency department nurses to undergo two hours of training in basic evidence collection, but that’s far from enough, Sheridan says. And while most facilities “either have a specific room that’s set aside in the ER or special private place for those patients,” she says, “without a forensic program or a forensic nurse, it’s just an ER bed.”

While certified forensic nurse examiners undergo extensive skills training, Sheridan believes graduate programs can move forensic nurses to the next level, with a deeper understanding of the science behind the evidence they’re collecting, helping them explain the pathology and ramification of victims’ injuries in a courtroom. For instance, she says that information helped the jury “make a better-informed” decision when she testified in two recent cases of strangulation.

Taking On Domestic Violence

Strangulation is one of the most frequent injuries in domestic violence, yet symptoms are subtle and often downplayed, says Heidi Marcozzi, coordinator of the Intimate Partner Violence Program, started last year as a branch of District of Columbia Forensic Nurse Examiners, which also works with victims of sexual assault.

Forensic nurses look not only for bruises and scratches, but less obvious symptoms such as petechiae (small red or purple spots on the skin), voice changes, cough and headaches, Marcozzi says. They ask patients about loss of bowel and bladder function, which is a good indicator that they lost consciousness during the attack.

“Domestic violence is a huge issue” in the nation’s capital, Marcozzi says. The program’s 30 forensic nurses respond to these calls from MedStar Washington Hospital Center, anytime day or night. Within an hour of getting the call for a domestic violence case, the forensic nurse arrives at the hospital, where ER staff have already made sure the patient is in a quiet, private space rather than the waiting room.

Before the exam, the forensic nurse walks the patient through the whole process. “We see a fair amount of drug-facilitated sexual assaults, so we want to make sure it’s very clear that the patient is able to consent,” Marcozzi says. “Then we do a medical exam head to toe to make sure they’re physically stable.” Nurses pays close attention while patients describe the incident and use that account to guide where they collect evidence, including swabs that will later go to the crime lab for analysis.

The FNE photographs any injuries and examines the patient using a high-powered light source that can reveal hard-to-see signs like bruising. The light also helps the nurse locate "foreign secretions ... things will fluoresce under certain wavelengths – semen, urine, saliva,” Marcozzi says.

More Than Just a ‘Rape Kit’

Victims of sexual assault go through essentially the same process, with the addition of a pelvic exam, which takes an additional 15 minutes or so. Examiners photograph the genitals for signs of injury, and then collect swabs as indicated. Treatment comes next. If appropriate, patients can receive Plan B emergency contraception to prevent unwanted pregnancy, or medications to protect against HIV and other prevalent sexually transmitted infections.

In sexual assault cases covered by DCFNE, an advocate with Network for Victim Recovery of DC accompanies the nurse to the hospital and helps patients with crisis management, discharge plans, crime victim’s compensation and referrals for counseling.

Preventing the Worst

For domestic violence victims, the DCFNE program teams up with Survivors and Advocates for Empowerment, a nonprofit that provides advocacy and crisis intervention, and works to hold offenders accountable. SAFE runs the lethality assessment project for the District of Columbia – trying to determine which victims are at highest risk for being killed by their abusers.

Advocates evaluate the victim’s environment for cues – such as whether the abuser has easy access to weapons, or even “if there’s a child in the home who doesn’t belong to him, which, believe it or not, increases the severity of the risk,” says Natalia Marlow-Otero, SAFE director.

Of the 5,000 or so domestic violence cases SAFE sees each year, up to 1,900 are deemed high-lethality cases. Isolation is a “huge” factor among the women – and some men – who are victims of domestic violence. Isolation and abuse are even more prevalent among immigrant clients, Marlow-Otero says, so SAFE provides an English/Spanish helpline (1-866-962-5048). People can also call the National Domestic Violence Hotline at 1-800-799-7233 (1-800-​799-SAFE). ​

Source: http://health.usnews.com

Topics: violence, victims, nursing, safety, forensic nurse, forensic, survivors, examiners

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