Program to address reported rise in workplace violence

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Program to address reported rise in workplace violence

Security guards and police officers expect violence as part of their job but many would be surprised to know that health care workers experience aggression, too.

Carol Koronkiewicz (centre), a licensed practical nurse, instructs new hires Racheal Oludamiro and Mark Mantilla about non-violent crisis intervention techniques at Regina Pioneer Village. Techniques learned through this program help staff defuse potentially violent situations. Photo credit: Medical Media Services

“Spitting, yelling, swearing is a daily occurrence,” said Chris Norman, a registered nurse and a unit coordinator at Emergency. “Someone will demand service from you. Sometimes the patient is frustrated.  Sometimes they’re sick and they feel they should get care before someone else. There’s also staff-to-staff violence. Bullying-type behavior.

“It’s the nature of our work,” said Norman, who has had a patient pull a knife on him. “Whether that’s normal and okay, I don’t have that answer.”

According to the province’s Occupational Health and Safety Regulations, 1996, violencemeans the attempted, threatened or actual conduct of a person that causes or is likely to cause injury, and includes any threatening statement or behaviour that gives a worker reasonable cause to believe that the worker is at risk of injury.The violence or threat may be carried out by a colleague or a client, patient or resident.

In 2016-17, the number of reported incidents of violence among the Region’s 11,000 employees rose 74 per cent, to 535 cases from 307.

“The numbers are going up for two main reasons,” said Brent Kitchen, executive director of People and Safety. “The obvious reason is that staff is experiencing more incidents. Less obviously, staff is becoming less tolerant of violent behavior and reporting incidents.

Workplace violence has the potential to affect the quality of care provided, impact the health of those subjected to it, and cause staff to change or quit their jobs.

Although violence and the risk of violence may be common for some, that doesn’t mean it should be.

Regina Qu’Appelle Health Region (RQHR) takes the safety of its staff, practitioners and patients seriously with the aim of zero harm to patients, clients, residents, practitioners and staff. Establishing a Workplace Violence Prevention Program has been a 2016-17 organizational priority and a legislative and accreditation requirement. The violence prevention program will aid in identifying and addressing acts of violence and areas of risk and ensure employees have the appropriate training and mechanisms to report, investigate, follow-up on and mitigate or resolve incidents and situations.

As part of the implementation process, a policy outlining roles and responsibilities has been created (Violence Prevention Policy), a steering committee comprised of regional directors and executive directors as well as patient/family representatives has been formed and, in the past year, violence risk assessments of every RQHR facility and unit – more than 200 areas – have been conducted by the Staff Safety Dept. From these assessments, the steering committee created risk profiles and is in the process of completing recommendations for each portfolio.

“The assessments looked at several factors – the risks created by the physical or working environment, whether staff does community visits and where, the type of care provided, and the type of patients/residents/clients being cared for. 

Some of the most common risks identified were poor lighting, inadequate building security, inoperable panic buttons, no dedicated space to deal with violent situations, no consistent way for those who visit patients/clients in the community to communicate whether they are safe and imperfect methods for identifying and communicating which patients/clients/residents are at risk of violent behavior.

“Through the assessments, we’re learning where our biggest gaps exist – where we are least prepared to deal with the risk of violence – we’ll work on those areas first. Some areas may be high risk but they have the right training, a buddy system, the right physical environment, etcetera, to keep people safe. These areas are not at the top of the list.”

Kitchen said the steering committee has developed strategies to reduce violence and is in the process of implementing them. “One opportunity for improvement is a better process to identify and communicate when a patient may be prone to violent behaviour – knowing what may trigger this behaviour – in order to prevent a violent situation.”

Next steps include education and training.

 “Safety consultants have reviewed the training taking place within and outside the organization and found that it’s inconsistent, occurring in pockets.

“We plan to clarify and standardize training so that it’s tailored for each provider group. In situations where the risk is low, basic training is required.  Where the risk is high, employees need a lot of expertise.”

If you are experiencing workplace violence

. . . or the threat of violence, please speak with your manager and report your experience through the employee incident reporting process. If you need counselling to help you deal with violence you’ve experienced, contact theEmployee Family Assistance Program or your employee health nurse.

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