Managing the Risk of Workplace Violence to Healthcare and Community Service Providers - pamphlet
International evidence shows that violence in the Healthcare and Community Service sectors is a significant hazard that must be urgently addressed by employers, healthcare workers, their clients and the community at large.
Violent incidents involving healthcare providers are often under-reported. However, it is wrong to accept that exposure to violence is “just part of the job.” Acts of violence can cause both physical and long-term psychological injuries, such as loss of morale and confidence, or significant psychological stress. This, in turn, can lead to poor productivity, high staff turnover levels and a decline in service standards.
Violence in the Healthcare and Community Service sectors may never be completely eliminated, given the nature of the care these providers supply. However, employers, employees and others with duties under the Health and Safety in Employment Act 1992 can take all practicable steps to identify and manage these hazards without compromising patient care.
A Good Practice Guide has been prepared by the Occupational Health and Safety Unit of the Counties Manukau District Health Board and the Department of Labour that provides strategies all healthcare providers can use to help reduce incidents of violence in their workplaces.
Health Care Professionals
Health professionals, particularly community health care providers, mental health workers and social workers
Needs assessors, home care providers
Front line reception staff
Security, porter/orderly staff, family members, volunteer workers and teachers in healthcare environments
Violence can potentially occur in any part of a healthcare facility where members of the public and workers directly interact with each other. Examples include:
Health Care Providers
Hospitals and clinics, accident and emergency clinics, general practice clinics, alcohol and drug services
Aged care facilities, community-based residential services, residences for physically and intellectually disabled persons, home-care services , private homes
Day Care Centres
Drop-in centres, day programme centres, all-night shelters, education centres for physically and intellectually disabled persons; vocational services, e.g. community participation, supported employment and sheltered workshops
Youth offender homes; services provided under the Intellectually Disabled Compulsory Care and Rehabilitation legislation
The Good Practice Guide provides detailed information, and case studies, of strategies that can be used to minimize workplace violence. Examples of practicable steps that every organization should have include:
- Acknowledging and identifying hazards related to workplace violence
- Facility Design –ensuring that the premises used for these services (as far as is practicable) are designed for their purpose and meet appropriate standards.
- Training - training employees about potential warning signs or cues of violence before an incident occurs:
|Warning signs/cues of violence||Responses that may help diffuse violence|
|Repeated succession of questions||Appear calm, self-controlled and confident, confirming that you are addressing their concerns.|
|Using another language in an aggressive manner||Identify language origin and locate interpreter to assist.|
|Using obscenities or sarcasm||Do not match their language.|
- Information Transfer – Ensuring that information about each client is available to caregivers and is sent with the client onward to other carers.
- Employee Participation - involving employees in the application of the Good Practice Guide.
- Management Plans – ensure that the response to violence or potential violence is taken into account in client care plans
The Guide provides detailed information on many other opportunities to minimize violent incidents in healthcare environments:
Deploying caregivers in tasks
- Job design
- Work organisational practices
- Security arrangements
- Lone working arrangements
- Enough staff to work safely
- Pre-employment selection criteria
- Employee education, training and supervision
- Supervisor and management training
- Situation monitoring
- Employee participation in health and safety
- Employee responsibilities for health and safety
- Personal protective equipment
- Well-rehearsed emergency response plans
- Security arrangements
The Guide also provides management information for use after a violent incident has occurred.
The Guide contains a number of assessment forms that healthcare providers can adapt for their own use. A number of scenarios have been developed as examples using these forms, including:
- Elderly Care Unit
- Maternity Services
- Mental Health Unit
The Guide has also reproduced, with permission, examples of violence prevention policies from an Australian hospital.
The Guide promotes a “zero tolerance” approach to violence against staff. The Department of Labour encourages all Healthcare Service Providers to download the Good Practice Guide, and with the assistance of employees, use the principles in this document to successfully manage this serious problem in the healthcare sector.
For further information on health, safety, employment and immigration issues, visit the Department of Labour website at www.dol.govt.nz, or phone our toll-free number 0800 20 90 20.