Transcript No Slide Title

OSHA’s Workplace Violence
Prevention Program
What Is Workplace Violence?
Any physical assault, threatening behavior, or verbal
abuse occurring in the workplace.
The workplace may be any location either permanent or
temporary where an employee performs any work-related
duty.
Types of Serious Injuries and Deaths
from Workplace Violence
•
•
•
•
•
Physical assaults
Beatings/stabbings
Shootings
Rapes
Attempting to cause physical harm, i.e..,
striking, pushing, or other aggressive acts
against another person
Acts of Aggression
Which May Indicate Risk
• Disorderly conduct, such as shouting,
pushing or throwing objects, punching walls,
or slamming doors;
• Verbal threats to inflict bodily harm including
vague or overt threats;
• Fascination with guns or other weapons,
demonstrated by discussions or bringing
weapons to workplace;
Acts of Aggression Which May
Indicate Risks (Continued)
• Obscene phone calls;
• Intimidating presence; and
• Harassment of any nature.
Types of Workplace
Violence Incidents
• Based upon the relationship between the
assailant/worker/workplace, violent incidents
can be divided into categories:
– Violence by strangers
– Violence by customers/clients/patients
– Violence by co-workers
– Violence by personal relationship
Types of Workplace Violence
Incidence (Continued)
Homicides
Leading cause of job-related deaths for women, second
leading cause for men.
Claimed the lives of 1,071 workers in 1994; approximately
3 workers died each day under violent circumstances.
Nonfatal Assaults
Between 1987-1992, one million persons were annually
assaulted at work.
Establishments Affected by
Workplace Violence
According to the Bureau of Labor Statistics, the
highest number of homicides occur in night retail
establishments.
The highest number of nonfatal assaults occur in
the health care and social service sectors.
Establishments Affected by
Workplace Violence (Continued)
• Workers in retail establishments, such as
convenience stores, retail groceries and
restaurants account for one half of all homicides.
• Work-related homicide rate for gas station
attendants and sales counter clerks exceeded by
10 times the national average.
• Workers at greatest risk are those who work alone,
late at night, and are known to handle cash.
Establishments Affected By
Workplace Violence (Continued)
Almost two thirds on nonfatal assaults occurred in
service industries, such as nursing homes, hospitals, and
establishments providing residential care and other
social services (i.e.., halfway homes) with a:
- rate of 47 per 10,000 workers workers for residential care.
- rate of 38 per 10,000 workers for nursing and personal care
facilities.
This is compared to 3 cases per 10,000 workers for all of
private industry.
Health Care Establishments
Nonfatal assaults were primarily by patients on
nursing staff in health care institutions.
According to one study (Goodman et al. 1994),
between 1980-1990, 106 violence-related deaths
occurred among health care workers.
Why Health Care Workers Are At Risk
of Work-Related Assaults - Examples
• Prevalence of handguns and other weapons
among patients, their families, or friends;
• Increasing number of acute and chronically
mentally ill patients being released from
hospitals without follow-up care;
• Availability of drugs or money at hospitals,
clinics, and pharmacies;
Why Health Care Workers Are At Risk of
Work-Related Assaults - Examples
(Continued)
• Low staffing level during times of specific
increased activity;
• Isolated work with clients during examinations or
treatment; and
• Poorly lighted parked areas.
Economic Impact of
Workplace Violence
• According to the Department of Justice, assaults at
work cost 500,000 employees 1,175,100 lost work
days each year.
• Annual cost of lost wages totals more than $55
million.
• When the cost of productivity, legal expenses,
property damage, diminished public image, increased
security and other factors are included, the cost is
measured in billions of dollars.
OSHA’s Commitment to
Workplace Violence
Published and distributed Guidelines for Preventing
Workplace Violence for Health Care and Social Services
Workers 3/96.
Plans to conduct a coordinated effort consisting of
research, information, training, cooperative programs,
and appropriate enforcement to address issue of
workplace violence.
Occupational Safety and
Health Act
The OSH Act of 1970 mandates that, in addition to
compliance with hazard-specific standards, all
employers have a general duty to provide their
employees with a workplace free from recognized
hazards likely to cause death or serious physical harm.
This includes the prevention and control of the hazard
of workplace violence.
OSHA will rely on Section 5 (a) (1) of the OSH Act (the
“General Duty Clause”) for enforcement authority.
Overview of the Guidelines
The guidelines are:
• Not a new standard or regulation
• Advisory in nature and informational in content
• Intended for use by employers who are seeking
to provide a safe and healthful workplace through
effective workplace violence prevention programs
Overview of Guidelines
(Continued)
The guidelines are based on the 1989 generic Safety
and Health Program Management Guidelines.
Although not exhaustive, the new workplace violence
guidelines include policy recommendations and
practical corrective methods to help prevent and
mitigate the effects of workplace violence.
Workers Covered by Guidelines
The guidelines cover a broad spectrum of
workers including, but not limited to the
following:
–
–
–
–
–
–
Physicians
Registered Nurses
Pharmacists
Home Health Nurses
Social/Welfare Workers
Emergency Medical Care Personnel
Four Components of Guidelines
• Management Commitment and
Employee Involvement
• Worksite Analysis
• Hazard Prevention and Control
• Training and Education
Management Commitment and
Employee Involvement
• Management commitment and employee
involvement are complementary elements of
an effective safety and health program.
• Management commitment provides the
motivating forces to deal effectively with
workplace violence.
• Employee involvement and feedback enable
workers to develop and express their
commitment to safety and health.
Management Commitment
Demonstrated by:
• Organizational concern for employee physical
and emotional safety and health;
• Equal commitment to worker safety and health
and patient/client safety; and
• A system of accountability for involved managers
and employees.
Employee Involvement
Should include the following:
• Understanding and complying with the workplace
violence program and other safety and security
measures;
• Participating in an employee complaint or
suggestion procedure covering safety and security
concerns; and
• Prompt and accurate reporting of violent incidents.
Written Program
A written program for job safety and security:
• Should be incorporated into the larger
organization’s overall safety and health program;
• Must provide clear goals and objectives to
prevent workplace violence; and
• Must be adaptable to specific situations in each
establishment.
Written Program (Continued)
• The workplace violence prevention program
should do the following:
– Create and disseminate a clear policy of zerotolerance for workplace violence, verbal and
nonverbal threats and related actions;
– Ensure that no reprisals are taken against an
employee who reports or experiences
workplace violence;
Written Program (Continued)
– Encourage employees to promptly report
incidents and to suggest ways to reduce or
eliminate risks:
– Outline a comprehensive plan for maintaining
security in the workplace;
– Assign responsibilities and authority for the
program to individuals or teams with
appropriate training and skills;
Written Program (Continued)
– Affirm management commitment to a workersupportive environment that places as much
importance on employee safety and health as
on serving the patient or client; and
– Set up a company briefing as part of the initial
effort to address such issues as preserving
safety, supporting affected employees, and
facilitating recovery.
Worksite Analysis
Worksite analysis involves a step-by-step common
sense look at the workplace to find existing or
potential hazards for workplace violence.
This entails reviewing specific procedures or
operations that contribute to hazards and specific
locales where hazards may develop.
Worksite Analysis (Continued)
A “Threat Assessment Team,” Patient Assault Team,”
similar task force, or coordinator may assess the
vulnerability to workplace violence and determine
appropriate actions.
The team should include representatives from senior
management, operations, employee assistance, security,
occupational safety and health, legal, and human
resources staff.
Worksite Analysis (Continued)
• The recommended program for worksite
analysis includes, but is not limited to:
–
–
–
–
Analyzing and tracking records;
Monitoring trends and analyzing incidents;
Screening surveys; and
Analyzing workplace security.
Worksite Analysis (Continued)
Record analysis should include:
• Reviewing medical, safety, and workers’
compensation and insurance records to pinpoint
incidents of workplace violence;
• Scanning unit logs and employee and police reports
of incidents or near-incidents of assaultive behavior;
and
• Tabulating the data to target frequency and severity
of incidents to establish a baseline for measuring
improvement.
Worksite Analysis (Continued)
Monitoring trends and analyzing incidents
include:
• Contacting similar local businesses, trade
associations, and community and civic groups to
learn about their experiences with workplace
violence; and
• Tracing trends of injuries and incidents of actual
or potential workplace violence.
Worksite Analysis (Continued)
Screening surveys include:
• Giving employees questionnaires to get their ideas on
the potential for violent incidents and to help identify or
confirm the need for improved security measures;
• Pinpointing tasks that put employees at risk;
• Identifying new or previously unnoticed risk factors and
deficiencies or failures in work practices, procedures, or
controls; and
• Assessing the effects of changes in the work processes.
Worksite Analysis (Continued)
Workplace security analysis includes:
• Analyzing incidents, including the characteristics of
assailants and victim and relevant details of the
situations;
• Identifying jobs, locations, processes, and
procedures with the greatest risk of violence;
• Noting high-risk factors such as the types of clients or
patients and physical risk factors of the building; and
• Evaluating the effectiveness of existing security
measures, including engineering control measures.
Hazard Prevention and Control
After the hazards of violence are identified through
systematic worksite analysis, the next step is to
design measures through engineering or
administrative and work practices to prevent or control
these hazards.
If violence does occur, post-incidence response can
be an important tool in preventing future incidents.
Hazard Prevention
and Control (Continued)
Engineering controls remove the hazards from the
workplace or create a barrier between the worker
and the hazards. Examples include:
Alarm systems and other security devices;
Metal detectors - closed circuit video recording for
high-risk areas; and
Safe rooms for employees use during emergencies.
Hazard Prevention
and Control (Continued)
Administrative and work practice controls affect the way
jobs or tasks are performed. Examples include:
Stating clearly to patients, clients, and employees that
violence is not tolerated or permitted;
Establishing liaison with local police and state prosecutors;
Requiring employees to report all assaults or threats to a
supervisor or manager; and
Setting up trained response teams to respond to emergencies.
Hazard Prevention and Control
(Continued)
Post-incident response and evaluation are essential to
an effective violence prevention program.
All workplace violence programs should provide
comprehensive treatment for victimized employees and
employees who may be traumatized by witnessing a
workplace violence incident.
Hazard Prevention and Control
(Continued)
• Several types of assistance can be
incorporated into the post-incident response
including:
– Trauma-crisis counseling;
– Critical incident stress debriefing; or
– Employee assistance programs to assist
victims.
Training and Education
Training and education ensure that all staff are aware
of potential security hazards and how to protect
themselves and their co-workers through established
policies and procedures.
Training and Education
(Continued)
Employee Training
Every employee should understand the concept of “Universal
Precautions for Violence,” i.e.., that violence should be
expected but can be avoided or mitigated through
preparation.
Staff should be instructed to limit physical interventions in
workplace altercations whenever possible, unless there are
adequate number of staff or emergency response teams and
security personnel available.
Training and Education
(Continued)
Employee Training
The training program should involve all employee including
supervisors and managers. New and reassigned
employees should receive an initial orientation prior to
being assigned their job duties.
Qualified trainers should instruct at the comprehension level
appropriate for all staff. The training should involve role
playing, simulations, and drills and should be provided to
employees annually.
Training and Education
(Continued)
Training should cover topics such as:
• The workplace violence prevention policy;
• Risk factors that cause or contribute to assaults;
• Early recognition of escalating behavior or recognition of
warning signs and situations that may lead to assaults;
and
• Ways of preventing or diffusing volatile situations or
aggressive behavior, managing anger, and appropriating
using medications as chemical restraints.
Training and Education
(Continued)
Supervisors, Managers, and Security Personnel
Supervisors and managers should ensure that employees are
not placed in assignments that comprise safety and should
encourage employees to report incidents. In addition, they
should learn how to reduce security hazards and ensure that
employees receive appropriate training.
Security personnel need specific training from the hospital or
clinic, i.e.., ways to handle aggression and defuse hostile
situations.
Training and Education
(Continued)
The training program should also include an
evaluation.
The content, methods, and frequency of training
should be reviewed and evaluated annually by the
team or coordinator responsible for implementation.
Recordkeeping and
Evaluation of the Program
Recordkeeping and evaluation of the violence
prevention program are necessary to determine the
overall effectiveness and identify any deficiencies or
changes that should be made.
Program evaluation may involve supervisor and/or
employee interviews, testing, and observing, and/or
reviewing reports of behavior of individuals in
threatening situations.
Recordkeeping
• Recordkeeping is essential to the success of
a workplace violence prevention program.
The following records are important:
– OSHA Log of Injury and Illnesses (OSHA 200);
– Medical reports of work injury and
supervisors’ reports of each recorded assault;
– Incidents of abuse, verbal attacks or aggressive
behavior;
Recordkeeping (Continued)
– Information on patients with a history of
past violence, drug abuse, or criminal
activity;
– Minutes of safety meetings, records of
hazard analyses, and corrective actions;
and
– Records of all training programs.
Evaluation
• As part of their overall program, employers
should evaluate their safety and security
measures. An evaluation program should
involve the following:
– Establishing a uniform violence reporting
system and regular review of reports;
– Reviewing reports of minutes from staff
meetings on safety issues;
Evaluation (Continued)
– Analyzing trends and rates in illness/injury
or fatalities caused by violence relative to
initial or “baseline” rates; and
– Measuring the effectiveness of
improvements based upon lowering the
frequency and severity of workplace
violence.
Sources of Assistance
• To assist in implementing an appropriate workplace
violence prevention program, employers can turn to
the following:
– OSHA Consultation Service
– National Institute of Occupational Safety and Health
– Public Safety Officials
– Trade Associations
– Unions and Insurers
– Human Resource and Employee Assistance
Professionals
Summary
OSHA recognizes the importance of effective safety
and health program management in providing safe and
healthful workplaces.
OSHA’s violence prevention guidelines are an essential
component to workplace safety and health programs.
OSHA believes that the performance-oriented approach
of the guidelines provide employers with flexibility in
their efforts to maintain safe and healthful working
conditions.