OSHA s Workplace Violence Guidelines: Risks and Expectations 10/26/2015 OSHA? OSHA Workplace Violence Timeline:

Transcription

1 OSHA s Workplace Violence : Risks and Expectations ALABAMA NURSING HOME ASSOCIATION NOVEMBER 2, 2015 OSHA? Occupational Safety and Health Administration Created under the OSH Act of 1970 Initiated in 1971 as a Federal Agency Purpose:...to assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources... OSHA Workplace Violence Timeline: Purpose of the Timeline: 1. To show OSHA s 4+ year progression toward Workplace Violence enforcement 2. To identify areas where OSHA recognizes Workplace Violence as a Serious Hazard in the work environment 3. Solidify OSHA s intent to inspect, enforce, and fine when necessary, employers that fail to prevent potential acts of workplace violence 1

2 OSHA s FIRST Workplace Violence Directive DIRECTIVE NUMBER: CPL EFFECTIVE DATE: September 8, 2011 SUBJECT: Enforcement Procedures for Investigating or Inspecting Workplace Violence Incidents OSHA s FIRST Workplace Violence Directive Highlights: This instruction establishes general policy guidance and procedures for field offices to apply when conducting inspections in response to incidents of workplace violence This is the first instruction on the enforcement procedures for investigations and inspections that occur as a result of workplace violence incident(s) and specifically at worksites in industries that OSHA has identified as susceptible to workplace violence. It clarifies and expands the Agency s policies and procedures in this area OSHA s FIRST Workplace Violence Directive OSHA-Identified High-Risk Industries Healthcare and Social Service Settings This category covers a broad spectrum of workers who provide healthcare and social services in psychiatric facilities, hospital emergency departments, community mental health clinics, drug abuse treatment clinics, pharmacies, community-care facilities, residential facilities and long-term care facilities 2

3 How does OSHA define Workplace Violence? Workplace Violence DEFINED: 1. Type 1 Criminal Intent Violent acts by people who enter the workplace to commit a robbery or other crime or current or former employees who enter the workplace with the intent to commit a crime. 2. Type 2 Customer/Client/Patients Violence directed at employees by customers, clients, patients, students, inmates or any others to whom the employer provides a service. How does OSHA define Workplace Violence? Workplace Violence DEFINED: 3. Type 3 Co-worker Violence against co-workers, supervisors, or managers by a current or former employee, supervisor, or manager. 4. Type 4 Personal Violence in the workplace by someone who does not work there, but who is known to, or has a personal relationship with, an employee. OSHA Press Release (#2) Release Number: NAT November 9, 2011 Statement from Assistant Secretary of Labor for OSHA on increase of nonfatal occupational injuries among health care workers OSHA to focus on improving safety and health at nursing home facilities 3

4 OSHA Press Release (#2) "The rates of injuries and illnesses among hospital and health care workers underscore OSHA's concern about the safety and health of these workers. OSHA is responding by launching, in the next few months, a National Emphasis Program on Nursing Home and Residential Care Facilities Through this initiative, we will increase our inspections of these facilities, focusing on back injuries from resident handling or lifting patients; exposure to bloodborne pathogens and other infectious diseases; workplace violence; and slips, trips and falls. OSHA Press Release (#2) "The workers that care for our loved ones deserve a safe workplace and OSHA is diligently working to make this happen." New OSHA Enforcement Memorandum (June 25, 2015). All inspections of hospitals, nursing homes, rehabilitation and social service facilities will include the review of all of these potential hazards: o Musculoskeletal disorders (MSD) related to patient handling; o Bloodborne pathogens; o Workplace violence; o Tuberculosis; and o Slips, trips and falls. 4

5 OSHA defines Workplace Violence as an assault, intimidating act, or threatening conduct which occurs in or is related to the workplace. In healthcare, OSHA considers resident/patient to caregiver/nurse violence as workplace violence that must be protected against even when the individual does not have the necessary intent. o Examples include: biting, hitting, kicking, spitting, stabbing, pushing, threatening to hurt, etc. OSHA s suggested abatement: o personal pendant wireless alarms carried by staff, o private walkie-talkies, o security cameras, o alarm systems, o metal detectors, o additional lighting in alcoves, curved mirrors, o furniture mounted to walls and floors, o plastic cutlery and glassware, o intercom call buttons placed onto walls above beds, o safe rooms and swipe card-enabled doors. Expectations: Create an anti-violence program that : o Includes an anti-violence statement that covers all workers, patients, clients, visitors and anyone else who may come in contact with personnel. o Identifies potential outcomes taken if the policy is violated, including discipline of employees, law enforcement contacted, or removal of visitors and residents. o Encourages prompt reporting and investigation of all incidents. o Records incidents to assess risk and to measure progress. 5

6 Define Workplace Violence: Clearly define what will be considered violence in the workplace from employees, visitors, and residents or patients such as: o Screaming and kicking o Biting o Pushing and shoving o Insults and practical jokes o Threats of physical violence o Physical or mental intimidation Hazard Analysis: Complete a workplace violence hazard assessment: o Identify residents and patients with the greatest risk of provoking violence, as well as actions that could put employees at risk of assault, including how often and when. o Perform resident/patient assessments. Determine the behavioral history of new and transferred residents/patients to learn about past violent or aggressive behavior. Communicate with staff! o The assessment should consider whether certain physical changes or administrative controls can reduce employee vulnerability to violent incidents Job Analysis: Employers are encouraged to perform job analysis to identify specific tasks or positions that may put employees at risk for workplace violence o Identify jobs or locations with the greatest risk of violence o Priority should be given to jobs that require: administering medicine providing intimate care activities transferring patients or residents 6

7 Risk Factors: Working directly with: o Patients and residents with a history of violence. o Patients and residents with cognitive disabilities or impairments. o Patients and residents with certain psychological disorders. o Patients and residents who have abused drugs or alcohol. o The public or with relatives of patients and residents. Lack of emergency communication devices or ability to get help. Long waits for care and services. OTHER Tools: Employee Surveys Track and Trend Events OSHA Expectations: Engineering Controls Example: Install and regularly maintain alarm systems and other security devices, such as panic buttons, hand-held alarms or noise devices. Administrative Controls Example: Prepare contingency plans to treat clients who are acting out or making verbal or physical attacks or threats. Communication is KEY to Prevention: Develop a method for communicating that a resident or patient has a history of violence with caregivers. Develop a method for notifying caregivers when a resident is acting out or has engaged in violent behavior. Develop a method for identifying controls that should be used for residents and patients after assessment. Notify caregivers what they should do if they believe violence is imminent. 7

8 Develop Procedures for the Following: Complaint Procedures: NOTE: Include an anti-retaliation provision and make sure that employees know that they will not be retaliated against for bringing a complaint of violence or bullying to management s attention or for participating in an investigation. Investigation Procedures Allegations Post-Incident Post-Incident Services TRAINING!! Program Evaluation General Duty Clause Section 5(a)(1) of the OSH Act requires: "Each employer shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees." General Duty Clause (Cont d) The general duty clause is used only where there is no OSHA standard that applies to the particular hazard involved. Examples of workplace hazards to which the general duty clause may apply include: Ergonomics, Occupational Exposure to TB and Workplace Violence. 8

9 General Duty Clause (Cont d) Four elements are required for issuing general duty clause violations: 1. The employer failed to keep the workplace free of a hazard to which employees of that employer where exposed 2. The hazard was recognized 3. The hazard was causing or was likely to cause death or serious physical harm 4. There was a feasible and useful method to correct the hazard Workplace Violence Training Training Materials: OSHA Workplace Violence Prevention Overview Health Care and Social Service Workers PowerPoint Presentation HTML Version PPT* KB Handouts [PDF KB] OSHA Publication 3148 [PDF KB] Recommendations: Safety Committee Virtually all safety committee activities involve some combination of the following: Hazard Assessment Review, Hands-on Inspections Incident Review ( near miss ) Review and trending of events Training and Education Review, revision, development of employee training Safety Management Organize and make valid recommendations for management changes 9

10 Safety & Health Program Development Nursing Home etool home/index.html Safety & Health Program Development Sample Safety and Health Programs for Small Business (OSHA) health/mod2_sample_sh_progra m.html Michael Arther, NHA MCA Consulting, LLC