Mark Thill

Universal Precautions for Violence

Unfortunately, all of us have been hearing a lot – too much – about violence in our streets, houses of worship, schools, homes. The hospital is no exception.

Between 2011 and 2013, workplace assaults ranged from 23,540 and 25,630 annually – and 70 to 74% occurred in healthcare and social service settings, according to the Occupational Safety and Health Administration in its 2015 “Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers.” For healthcare workers, assaults comprise 10 to 11% of workplace injuries involving days away from work, as compared to 3 of injuries of all private sector employees.

Among the many things that caught my attention in the guidelines was OSHA’s use of the term “universal precautions for violence.” Violence should be expected, says the agency. “But it can be avoided or mitigated through preparation. In addition, workers should understand the importance of a culture of respect, dignity and active mutual engagement in preventing workplace violence.”

Supply chain professionals have no control over staffing in clinical areas, the crime rate of the surrounding community or the time of days employees must work. But they can help mitigate the impact of violence. The OSHA Guidelines offer a series of checklists for all hospital executives and managers to review. Some examples:

  • Are areas where money is exchanged visible to others who could help in an emergency? (For example, can you see cash register areas from outside?)
  • Are waiting areas and work areas free of objects that could be used as weapons?
  • Are patient or client waiting areas designed to maximize comfort and minimize stress?
  • Is furniture in waiting and work areas arranged to prevent workers from becoming trapped?
  • Are private, locked restrooms available for employees?
  • Is there a secure place for workers to store personal belongings?
  • Do workers feel safe walking to and from the workplace?
  • Is lighting bright and effective in outside areas?
  • Does the workplace have panic buttons? Metal detectors? Security mirrors? An internal telephone system to contact emergency assistance?
  • Are workers trained in the emergency response plan (for example, escape routes, notifying the proper authorities)?
  • Are workers trained in ways to prevent or defuse potentially violent situations?
  • Are reception and work areas designed to prevent unauthorized entry?
  • Are people who work in the field late at night or early mornings advised about special precautions to take?

OSHA suggests that we expect and prepare for violence in the workplace, just as we do bloodborne pathogens. Violence just calls for a different set of universal precautions.

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