From 2012 to 2014, workplace violence injury rates increased for all healthcare job classifications and nearly doubled for nurse assistants and nurses, according to data from the Occupational Health Safety Network (OHSN).
The U.S. Occupational Safety and Health Administration (OSHA) recently updated its workplace violence prevention guidelines for the health care and social services industry. You can find this comprehensive handbook here (PDF link).
- Health care workplace violence strikes at many settings outside traditional hospitals, including:
Residential Treatment settings, which include institutional facilities such as nursing homes and other long-term care facilities;
- Non-residential Treatment/Service settings, which include small neighborhood clinics and mental health centers;
- Community Care settings, which include community-based residential facilities and group homes; and
- Field work settings, which include home healthcare workers or social workers who make home visits.
If your health care workplace is on this list you need to pay attention to the new OSHA guidelines.
The report also includes some disturbing statistics highlighting the increasing trend of workplace violence. Quoting from the guidelines:
According to the Bureau of Labor Statistics (BLS), 27 out of the 100 fatalities in healthcare and social service settings that occurred in 2013 were due to assaults and violent acts. While media attention tends to focus on reports of workplace homicides, the vast majority of workplace violence incidents result in non-fatal, yet serious injuries.
Statistics based on the Bureau of Labor Statistics (BLS) and National Crime Victimization Survey (NCVS) data both reveal that workplace violence is a threat to those in the healthcare and social service settings. BLS data show that the majority of injuries from assaults at work that required days away from work occurred in the healthcare and social services settings. Between 2011 and 2013, workplace assaults ranged from 23,540 and 25,630 annually, with 70 to 74% occurring in healthcare and social service settings. For healthcare workers, assaults comprise 10-11% of workplace injuries involving days away from work, as compared to 3% of injuries of all private sector employees.
Why does workplace violence hit health care sites? The guidelines expose multiple risk factors including:
- Lack of facility policies and staff training for recognizing and managing escalating hostile and assaultive behaviors from patients, clients, visitors, or staff;
- Working when understaffed—especially during mealtimes and visiting hours;
- High worker turnover;
- Inadequate security and mental health personnel on site;
- Long waits for patients or clients and overcrowded, uncomfortable waiting rooms;
- Unrestricted movement of the public in clinics and hospitals; and
- Perception that violence is tolerated and victims will not be able to report the incident to police and/or press charges.
One of the first things the guidelines recommend doing is a detailed health care worksite analysis and hazard assessment.
This is an “all hands on deck” approach made by a team that includes senior management, supervisors, workers, representatives from operations; employee assistance; security; occupational safety and health; legal; and human resources staff. The assessment should include a records review, a review of the procedures and operations for different jobs, employee surveys and workplace security analysis.
Every healthcare facility should do a proactive comprehensive annual worksite analysis as well as an investigative analysis after every incident or near miss.
The Soteria Group can help you with the on-site analysis, examining incident records, making physical and procedural change recommendations to your workspace, and providing training for every member of your staff. Let us help keep your health care workplace free from violence.