Page 10
be more supportive than traditional service delivery approaches, thus avoiding re-traumatization.8 8 Referenced on the Substance Abuse and Mental Health Services Administration’s website on February 25, 2013 (www.samhsa.gov/nctic). Occupational Safety and Health Administration 1 8 The following are possible administrative controls that could apply in different settings. Possible administrative and work practice controls for different healthcare and social service settings Hospital Residential Treatment Non-residential Treatment/Service Community Care Field Workers (Home Healthcare, Social Service) Workplace violence response policy x Clearly state to patients, clients, visitors and workers that violence is not permitted and will not be tolerated. x Such a policy makes it clear to workers that assaults are not considered part of the job or acceptable behavior. Tracking workers9 Traveling workers should: x have specific log-in and log-out procedures x be required to contact the office after each visit and managers should have procedures to follow-up if workers fail to do so Workers should: x have specific log-in and log-out procedures x be required to contact the office after each visit and managers should have procedures to followup if workers fail to do so x be given discretion as to whether or not they begin or continue a visit if they feel threatened or unsafe x Log-in/log-out procedures should include: x the name and address of client visited; x the scheduled time and duration of visit; x a contact number; x a code word used to inform someone of an incident/threat; x worker’s vehicle description and license plate number; x details of any travel plans with client; x contacting office/supervisor with any changes. Tracking clients with a known history of violence x Supervise the movement of patients throughout the facility x Update staff in shift report about violent history or incident x Update staff in shift report about violent history or incident x Report all violent incidents to employer 9 Massachusetts Department of Mental Health Task Force on Staff and Client Safety. (2011). Report of the Massachusetts Department of Mental Health Task Force on Staff and Client Safety. Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers 1 9 Hospital Residential Treatment Non-residential Treatment/Service Community Care Field Workers (Home Healthcare, Social Service) x Determine the behavioral history of new and transferred patients and clients to learn about any past violent or assaultive behaviors. x Identify any event triggers for clients, such as certain dates or visitors. x Identify the type of violence including severity, pattern and intended purpose. x Information gained should be used to formulate individualized plans for early identification and prevention of future violence. x Establish a system—such as chart tags, log books or verbal census reports—to identify patients and clients with a history of violence and identify triggers and the best responses and means of de-escalation. x Ensure workers know and follow procedures for updates to patients’ and clients’ behavior. x Ensure patient and client confidentiality is maintained. x Update as needed. x If stalking is suspected, consider varying check-in and check-out times for affected workers and plan different travel routes for those workers. Working alone or in secure areas x Treat and interview aggressive or agitated clients in relatively open areas that still maintain privacy and confidentiality x Ensure workers are not alone when performing intimate physical examinations of patients x Advise staff to exercise extra care in elevators and stairwells x Provide staff members with security escorts to parking areas during evening/ late hours— Ensure these areas are well lit and highly visible x Advise staff to exercise extra care in elevators, stairwells x Provide staff members with security escorts to parking areas during evening/ late hours. Ensure these areas are well lit and highly visible x Ensure workers have means of communication—either cell phones of panic buttons x Develop policy to determine when a buddy system should be implemented x Advise staff to exercise extra care in unfamiliar residences x Workers should be given