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engineering control measures that can effectively prevent or control workplace hazards. Engineering control strategies include: (a) using physical barriers (such as enclosures or guards) or door locks to reduce employee exposure to the hazard; (b) metal detectors; (c) panic buttons, (d) better or additional lighting; and (e) more accessible exits (where appropriate). The measures taken should be sitespecific and based on the hazards identified in the worksite analysis appropriate to the specific therapeutic setting. For example, closed circuit videos and bulletproof glass may be appropriate in a hospital or other institutional setting, but not in a community care facility. Similarly, it should be noted that services performed in the field (e.g., home health or social services) often occur in private residences where some engineering controls may not be possible or appropriate. Occupational Safety and Health Administration 1 4 If new construction or modifications are planned for a facility, assess any plans to eliminate or reduce security hazards. The following are possible engineering controls that could apply in different settings. Note that this is a list of suggested measures whose appropriateness will depend on a number of factors. Possible engineering controls for different healthcare and social service settings Hospital Residential Treatment Non-residential Treatment/ Service Community Care Field Workers (Home Healthcare, Social Service) Security/ silenced alarm systems x Panic buttons or paging system at workstations or personal alarm devices worn by employees x Paging system x GPS tracking7 x Cell phones x Security/silenced alarm systems should be regularly maintained and managers and staff should fully understand the range and limitations of the system. Exit routes x Where possible, rooms should have two exits x Provide employee ‘safe room’ for emergencies x Arrange furniture so workers have a clear exit route x Where possible, counseling rooms should have two exits x Arrange furniture so workers have a clear exit route x Managers and workers should assess homes for exit routes x Workers should be familiar with a site and identify the different exit routes available. Metal detectors – hand-held or installed x Employers and workers will have to determine the appropriate balance of creating the suitable atmosphere for services being provided and the types of barriers put in place. x Metal detectors should be regularly maintained and assessed for effectiveness in reducing the weapons brought into a facility. x Staff should be appropriately assigned, and trained to use the equipment and remove weapons. Monitoring systems & natural surveillance x Closed-circuit video – inside and outside x Curved mirrors x Proper placement of nurses’ stations to allow visual scanning of areas x Glass panels in doors/walls for better monitoring x Closed-circuit video – inside and outside x Curved mirrors x Glass panels in doors for better monitoring x Employers and workers will have to determine the appropriate balance of creating the suitable atmosphere for services being provided and the types of barriers put in place. x Staff should know if video monitoring is in use or not and whether someone is always monitoring the video or not. 7 Employers and workers should determine the most effective method for ensuring the safety of workers without negatively impacting working conditions. Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers 1 5 Hospital Residential Treatment Non-residential Treatment/ Service Community Care Field Workers (Home Healthcare, Social Service) Barrier protection x Enclosed receptionist desk with bulletproof glass x Deep counters at nurses’ stations x Lock doors to staff counseling and treatment rooms x Provide lockable (or keyless door systems) and secure bathrooms for staff members (with locks on the inside)— separated from patient/ client and visitor facilities x Lock all unused doors to limit access, in accord with local fire codes x Deep counters in offices x Provide lockable (or keyless door systems) and secure bathrooms for staff members (with locks on the inside)— separated from patient/ client and visitor facilities x Lock all unused doors to
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