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discretion to receive backup assistance by another worker or law enforcement officer x Workers should be given discretion as to whether or not they begin or continue a visit if they feel threatened or unsafe x Ensure workers have means of communication—either cell phones or panic buttons x Limit workers from working alone in emergency areas or walk-in clinics, particularly at night or when assistance is unavailable. x Establish policies and procedures for secured areas and emergency evacuations. x Use the “buddy system,” especially when personal safety may be threatened. Reporting x Require workers to report all assaults or threats to a supervisor or manager (for example, through a confidential interview). Keep logbooks and reports of such incidents to help determine any necessary actions to prevent recurrences. x Establish a liaison with local police, service providers who can assist (e.g., counselors) and state prosecutors. When needed, give police physical layouts of facilities to expedite investigations. Occupational Safety and Health Administration 2 0 Hospital Residential Treatment Non-residential Treatment/Service Community Care Field Workers (Home Healthcare, Social Service) Entry procedures x Provide responsive, timely information to those waiting; adopt measures to reduce waiting times x Institute sign-in procedures and visitor passes x Enforce visitor hours and procedures for being in the hospital x Have a “restricted visitors” list for patients with a history of violence/ gang activity; make copies available to security, nurses, and sign-in clerk x Institute sign-in procedures with passes for visitors x Enforce visitor hours and procedures x Establish a list of “restricted visitors” for patients with a history of violence or gang activity; make copies available at security checkpoints, nurses’ stations and visitor sign-in areas x Provide responsive, timely information to those waiting; adopt measures to reduce waiting times x Ensure workers determine how best to enter facilities x Ensure workers determine how best to enter clients’ homes Incident response/ high risk activities x Use properly trained security officers and counselors to respond to aggressive behavior; follow written security procedures x Ensure that adequate and qualified staff members are available at all times, especially during highrisk times such as patient transfers, emergency responses, mealtimes and at night x Ensure that adequate and qualified staff members are available to disarm and deescalate patients if necessary x Assess changing client routines and activities to reduce or eliminate the possibility of violent outbursts x Use properly trained security officers and counselors to respond to aggressive behavior; follow written security procedures x Ensure assistance if children will be removed from the home Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers 2 1 Hospital Residential Treatment Non-residential Treatment/Service Community Care Field Workers (Home Healthcare, Social Service) x Advise workers of company procedures for requesting police assistance or filing charges when assaulted—and assist them in doing so if necessary. x Provide management support during emergencies. Respond promptly to all complaints. x Ensure that adequately trained staff members and counselors are available to de-escalate a situation and counsel patients. x Prepare contingency plans to treat clients who are “acting out” or making verbal or physical attacks or threats. x Emergency action plans should be developed to ensure that workers know how to call for help or medical assistance. Employee uniforms/ dress x Provide staff with identification badges, preferably without last names, to readily verify employment. x Discourage workers from wearing necklaces or chains to help prevent possible strangulation in confrontational situations. x Discourage workers from wearing expensive jewelry or carrying large sums of money. x Discourage workers from carrying keys or other items that could be used as weapons. x Encourage the use of head netting/cap so hair cannot be grabbed and used to pull or shove workers. Facility & work procedures x Survey facility periodically to remove tools or possessions