OSHA likes to tout itself as a governmental agency that looks out for workers in all industries. But they aren’t doing a very good job of announcing a huge change to guidelines that could help protect healthcare workers from the rising problem of workplace violence.
It took a couple of well-connected readers to let me know that OSHA earlier in April released an update to its Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, known to many in the safety field as OSHA Rule 3148. Good luck finding any of this on the OSHA web site, by the way.
After an inquiry to OSHA public relations, I was sent the updated guidelines, which you should pay attention to if you are in charge of safety at your facility.
According to its own statistics, OSHA says in 2013 more than 23,000 significant injuries were caused due to assaults at work. More than 70 percent of these assaults were in healthcare and social service settings. Health care and social service workers are almost four times more likely to be injured as a result of violence than the average private sector worker, OSHA says. Further statistics show that about 27 out of the 100, or about 30% of the fatalities in healthcare and social service settings that occurred in 2013 were due to assaults and violent acts.
Under pressure to do something about this, the updated OSHA 3148 recommends that all healthcare facilities develop an effective workplace violence prevention program. Pay attention, because the word is that the Joint Commission is also following these changes closely.
The new OSHA guidelines are very specific in the types of workplace controls that employers should consider, especially when it comes to facility security and keeping track of employers. Examples include:
- The use of silent alarms and panic buttons in hospitals and medical clinics
- Providing safe rooms and arranging furniture to make sure there are clear exit routes for workers and patients
- Installing permanent or hand-held metal detectors to detect weapons, and providing staff training on the use of these devices
- Ensuring nurse stations have a clear view of all treatment areas, including the use of curved mirrors and installing glass panels in doors for better viewing, as well as closed circuit cameras to help monitor areas
- Using GPS, cell phones, and other location technology to help keep track of staff working with patients in off-site locations
- Protection front-end and triage staff using facility design elements such as deep counters, secure bathrooms for staff separate from patient treatment areas, and using bulletproof glass and lockable doors with keyless entry systems
In addition, the recommendations include employing administrative controls designed to track patients and visitors who have a history of violence, to better educate workers on the dangers and signs of impending violence, and to ensure better reporting procedures. Some of these recommendations include:
- Providing clear signage in the facility that violence will not be tolerated
- Instituting procedures that require off-site staff to log in and log out, as well as checking in with office managers periodically
- Keeping a behavioral history of patients, including identifying triggers and patterns
- If necessary, establish staggered work times and exit routes for workers who may be subjects of stalkers
- Keep a “restricted visitor” list for suspected violent people, such as gang members, and make sure all staff are made aware
Also, OSHA recommends that employers provide updated training for employees, including:
- Risk factors that cause or contribute to violent incidents
- Early recognition of escalating behavior or recognition of warning signs
- Ways to recognize, prevent or diffuse volatile situations or aggressive behavior, manage anger and appropriately use medications
- Proper use of safe rooms—areas where staff can find shelter from a violent incident;
- Self-defense procedures where appropriate
- How to apply restraints properly and safety when necessary
- Ways to protect oneself and coworkers, including use of the “buddy system”
For more information, the Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers can be found at https://www.osha.gov/Publications/osha3148.pdf