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limit access, in accord with local fire codes x Deep counters 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 Employers and workers will have to determine the appropriate balance of creating the suitable atmosphere for the services being provided and the types of barriers put in place. Occupational Safety and Health Administration 1 6 Hospital Residential Treatment Non-residential Treatment/ Service Community Care Field Workers (Home Healthcare, Social Service) Patient/client areas x Establish areas for patients/ clients to de-escalate x Provide comfortable waiting areas to reduce stress x Divide waiting areas to limit the spreading of agitation among clients/ visitors x Establish areas for patients/ clients to de-escalate x Provide comfortable waiting areas to reduce stress x Assess staff rotations in facilities where clients become agitated by unfamiliar staff x Provide comfortable waiting areas to reduce stress x Establish areas for patients/ clients to de-escalate x Establish areas for patients/ clients to de-escalate x Employers and workers will have to determine the appropriate balance of creating the suitable atmosphere for the services being provided and the types of barriers put in place. Furniture, materials & maintenance x Secure furniture and other items that could be used as weapons x Replace open hinges on doors with continuous hinges to reduce pinching hazards x Ensure cabinets and syringe drawers have working locks x Pad or replace sharp edged objects (such as metal table frames) x Consider changing or adding materials to reduce noise in certain areas x Recess any hand rails, drinking fountains and any other protrusions x Smooth down or cover any sharp surfaces x When feasible, secure furniture or other items that could be used as weapons x Ensure cabinets and syringe drawers have working locks x Pad or replace sharp edged objects (such as metal table frames) x Ensure carrying equipment for medical equipment, medicines and valuables have working locks x Ensure carrying equipment for medical equipment, medicines and valuables have working locks x Employers and workers will have to establish a balance between creating the appropriate atmosphere for the services being provided and securing furniture. Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers 1 7 Hospital Residential Treatment Non-residential Treatment/ Service Community Care Field Workers (Home Healthcare, Social Service) Lighting x Install bright, effective lighting—both indoors and outdoors on the grounds, in parking areas and walkways x Ensure lighting is adequate in both the indoor and outdoor areas x Work with client to ensure lighting is adequate in both the indoor and outdoor areas x Ensure burned out lights are replaced immediately. x While lighting should be effective it should not be harsh or cause undue glare. Travel vehicles x Ensure vehicles are properly maintained x Where appropriate, consider physical barrier between driver and patients x Ensure vehicles are properly maintained Administrative and work practice controls Administrative and work practice controls are appropriate when engineering controls are not feasible or not completely protective. These controls affect the way staff perform jobs or tasks. Changes in work practices and administrative procedures can help prevent violent incidents. As with engineering controls, the practices chosen to abate workplace violence should be appropriate to the type of site and in response to hazards identified. In addition to the specific measures listed below, training for administrative and treatment staff should include therapeutic procedures that are sensitive to the cause and stimulus of violence. For example, research has shown that Trauma Informed Care is a treatment technique that has been successfully instituted in inpatient psychiatric units as a way to reduce patient violence, and the need for seclusion and restraint. As explained by the Substance Abuse and Mental Health Services Administration, trauma-informed services are based on an understanding of the vulnerabilities or triggers of trauma for survivors and can
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