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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

Violence Prevention in Home Care Nursing

Posted by Erica Bettencourt

Fri, Jan 15, 2021 @ 03:15 PM

knockingThe need for in-home care has grown since COVID-19 because many fear contracting the virus in hospitals and clinics, especially among the elderly population.

With no security like hospitals usually have, home visiting Nurses put themselves at risk whenever they enter a patient's home alone. 

Ha Do Byon, Assistant Professor of Nursing at the University of Virginia School of Nursing mentions in a  STAT news article, "Even before the pandemic struck, I heard Nurses’ stories of home visits — some during my time as a visiting Nurse, and others as part of a study I am conducting to understand violence faced by home visiting Nurses. They told me about patients who blared pornography, or being groped while administering care. About patients who waved handguns and hurled racial insults. About being bitten, punched, kicked, or slapped. About dealing with screaming fits, intoxicated family members, and dogs that bit them or threatened to."

According to a 2015 study by BMC Public Health, the threat of workplace violence was one of home health workers’ top concerns, ranking above transportation issues or environmental hazards.

Developing a safety program for your home care workforce is crucial in reducing health care worker stress and turnover.

The rate of patient-on-Nurse violence among home visiting Nurses is unknown.

An article in Home Care Magazine states, only one-fifth of violent incidents “are ever reported in part due to embarrassment, organizational culture, tolerance or excusing the behavior of ‘ill’ clients." Nurses have cited fear of retribution from supervisors, the complexity of the legal system and disapproval from administrators as barriers to reporting workplace violence.

Nurses and providers can take measures to prevent violent situations.

The National Institute for Occupational Safety and Health Centers for Disease Control and Prevention released a list of recommendations for employers and workers to ensure safety.

Some recommendations for Employers:

• Ask employees to report each incident, even if they think it won’t happen again or it might not be serious.

• Train employees to recognize the signs and body language associated with violent assault and how to manage or prevent violent behavior, such as verbal de-escalation techniques, management of angry patients, recognizing and protecting themselves from gangs and gang behavior.

• In the case of an unacceptable home environment, advise the patient on working with social service agencies, the local police department, or family members and neighbors to make the home less hazardous so care can continue.

• Provide cell phones to all staff on duty. Home healthcare workers consider cell phones to be lifelines.

• Consider other equipment, such as employer-supplied vehicles, emergency alarms, two-way radios, and personal bright flashlights to enhance safety.

• Establish a no-weapons policy in patient homes. If such a policy is not required, request at a minimum that, before service is provided, all weapons be disabled, removed from the area where care is provided, and stored in a secure location.

• If possible, visits in high-crime areas should be scheduled during daylight hours.

Some recommendations for visiting Nurses:

•Acknowledge the person’s feelings.

• Avoid behaviors that may be interpreted as aggressive (for example, moving rapidly or getting too close, touching unnecessarily, or speaking loudly).

• If possible, keep an open pathway for exiting.

• Trust your own judgment; avoid situations that don’t feel right.

• If you cannot gain control of the situation, take these steps: Shorten the visit. Remove yourself from the situation. If you feel threatened, leave immediately.

• Use your cell phone to call your employer or 911 for help (depending on the severity of the situation).

• Report any incident of violence to your employer.

• If you are being verbally abused, ask the abuser to stop the conversation.— If the abuser does not stop the conversation, leave the premises and notify your employer.

• Consider working in pairs in high-crime areas.

• Always let your employer know where you are and when to expect you to report back.

• During the visit, use basic safety precautions:— Be alert.— Evaluate each situation for possible violence.— Watch for signals of impending violent assault, such as verbally expressed anger and frustration, threatening gestures, signs of drugs or alcohol abuse, or the presence of weapons.

• Maintain behavior that helps to diffuse anger:— Present a calm, caring attitude.— Do not match threats.— Do not give orders.

We view Nurses and healthcare workers as heroes and we should appreciate the essential work that home visiting Nurses provide by making sure they can safely do their job and feel comfortable enough to notify management when they aren't safe.

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Topics: home care, visiting nurse, nurse safety, Violence Prevention in Home Care Nursing, at home care, home care nursing, violence in the workplace

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