Workplace Hazards to Nurses and Other Healthcare Workers: Promising Practices for Prevention
Breakout Session Worksheet

Preventing Workplace Violence June 8, 2007

Speaker: Jane Lipscomb PhD, RN, University of Maryland, Department of Family and Community Health
MNA Facilitators: Rosemary O’Brien RN, Noreen Hogan RN, Janice Homer RN

Statement of the Problem
The Department of Justice National Crime Victimizations Survey (NCVS) for the years 1993 through 1999 found, on average, 1.7 million episodes of victimization at work per year (Duhart, 2001) the health care sector continues to lead all other industry sectors in the incidence of nonfatal workplace assaults. In 2000, 48% of all nonfatal injuries against workers occurred in the health care sector (BLS 2001). Nurses, nurse’s aides and orderlies suffer the highest proportion of these injuries. Non-fatal assaults on health care workers include assaults, bruises, lacerations, broken bones and concussions….* **McPhaul, PhD(c), RN, MPH, Lipscomb, Jane PhD, RN September 30, 2004 http://www.mursingworkd.org/ojin/topic25/tpc25_6.htm

JCAHO Regulation that relates to this topic: EC.1.10 Hospitals must manage safety risks, EC 1.20 Hospitals must maintain safe environments
OSHA Guideline/Standard that address this topic: Preventing Workplace Violence in Healthcare and Social Service Settings, General Duty Clause 5A-1- Employers must furnish a place of employment free from recognized hazards
OSHA recommended steps to provide a safe work environment - A. Management support and worker involvement, B. Hazard assessment and control, C. Training and education, D. Program evaluation

Items considered by the breakout session participants:

1. How are patients, visitors or others affected?

• Restraint reduction policies can cause increased risk of injuries for other patients and staff
• Vicarious traumatization can occur in those who witness violence

2. What are some good practices that you have seen in your workplace?

• Earlier intervention training
• Task force to analyze the problem
• More secure environment
• Shuttle services to protect staff in parking lots
• Culturally sensitive/competency programs

What are some of the barriers and opportunities associated with change? Barriers:

• • Insufficient time to interact with patients effectively
• No laws to protect staff
• Lack of understanding of HIPAA – misuse of HIPAA as a reason to prevent reporting violence to authorities, Visitors are not covered by HIPAA
• Management unwilling to address the problem
• Erroneous assumption that “It’s part of the job”

Opportunities:

• Not addressed in this session

What are some concrete steps that could be taken to address this problem?

• Organize a team to look at the problem
• Collect data, assess work area, analyze the findings, evaluate all to develop prevention strategies
• Consider patient safety as well as staff safety when collecting data and assessing work area
• Develop educational and prevention programs that are site/department specific
• Develop post response programs – Critical Incident Stress Management
• Work with local police, District Attorney and patient advocacy groups
• Collaborate with legislators for new laws related to workplace violence education and prevention
• Contact OSHA
• Support MNA Workplace Violence Prevention and Felony to Assault a Healthcare Worker legislative efforts
• Utilize external expert resources – Dr. David Yamada at Suffolk University – Bullying, OSHA Compliance Assistance – Workplace Violence Prevention Guidelines, MNA Workplace Violence and Abuse Prevention Task Force, MNA Health and Safety Staff, MA Victim Bill of Rights, MA Victim and Witness Advocacy Program

Who are the management people at your workplace who are responsible for worker health and safety and who are 5 people in your workplace who would help to address the issue?

• Occupational Safety Professionals
• Human Resource Management
• Supervisors, Department Managers
  Those who would help:
• Nurses and others who have been affected
• Union representatives

1/7/2008 3:10 PM To Mass Nurse Advocate/EB 1/7/2008 3:11 PM