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evaluation of the violence prevention program are necessary to determine its overall effectiveness and identify any deficiencies or changes that should be made. Supervisors and managers must be trained to recognize high-risk situations, so they can ensure that workers are not placed in assignments that compromise their safety. Occupational Safety and Health Administration 2 8 Accurate records of injuries, illnesses, incidents, assaults, hazards, corrective actions, patient histories and training can help employers determine the severity of the problem; identify any developing trends or patterns in particular locations, jobs or departments; evaluate methods of hazard control; identify training needs and develop solutions for an effective program. Records can be especially useful to large organizations and for members of a trade association that “pool” data. Key records include: ■ OSHA Log of Work-Related Injuries and Illnesses (OSHA Form 300). Covered employers are required to prepare and maintain records of serious occupational injuries and illnesses, using the OSHA 300 Log. As of January 2015, all employers must report: (1) all work-related fatalities within 8 hours and (2) all work-related inpatient hospitalizations, all amputations and all losses of an eye within 24 hours. Injuries caused by assaults must be entered on the log if they meet the recording criteria.11 ■ Medical reports of work injury, workers’ compensation reports and supervisors’ reports for each recorded assault. These records should describe the type of assault, such as an unprovoked sudden attack or patient-to-patient altercation, who was assaulted, and all other circumstances of the incident. The records should include a description of the environment or location, lost work time that resulted and the nature of injuries sustained. These medical records are confidential documents and should be kept in a locked location under the direct responsibility of a healthcare professional. ■ Records of incidents of abuse, reports conducted by security personnel, verbal attacks or aggressive behavior that may be threatening, such as pushing or shouting and acts of aggression toward other clients. This may be kept as part of an assaultive incident report. Ensure that the affected department evaluates these records routinely. ■ Information on patients with a history of past violence, drug abuse or criminal activity recorded on the patient’s chart. Anyone who cares for a potentially aggressive, abusive or 11 29 CFR Part 1904, revised 2014. Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers 2 9 violent client should be aware of the person’s background and history, including triggers and de-escalation responses. Log the admission of violent patients to help determine potential risks. Log violent events on patients’ charts and flagged charts.12 ■ Documentation of minutes of safety meetings, records of hazard analyses and corrective actions recommended and taken. ■ Records of all training programs, attendees, and qualifications of trainers. Elements of a program evaluation As part of their overall program, employers should evaluate their safety and security measures. Top management should review the program regularly and, with each incident, to evaluate its success. Responsible parties (including managers, supervisors and employees) should reevaluate policies and procedures on a regular basis to identify deficiencies and take corrective action. Management should share workplace violence prevention evaluation reports with all workers. Any changes in the program should be discussed at regular meetings of the safety committee, union representatives or other employee groups. All reports should protect worker and patient confidentiality either by presenting only aggregate data or by removing personal identifiers if individual data are used. Processes involved in an evaluation include: ■ Establishing a uniform violence reporting system and regular review of reports; ■ Reviewing reports and minutes from staff meetings on safety and security issues; ■ Analyzing trends and rates in illnesses, injuries or fatalities caused by violence relative to initial or “baseline” rates; ■ Measuring improvement
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