GET THE EVIDENCE TO SUPPORT ENFORCEMENT AND APPEALS

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Percival Arnold
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1 GET THE EVIDENCE TO SUPPORT ENFORCEMENT AND APPEALS For every icidet or threat of workplace violece, ONA eeds to gather evidece to make the employer do its job to protect workers ad to make the Miistry of Labour (MOL) eforce the law. Whe the MOL does t issue orders ad/or prosecute, we ca use that evidece to appeal the MOL s decisio. ONA oly has 30 days to appeal a decisio of a ispector. You have the right to kow ad the employer must provide iformatio (e.g. ivestigatio reports, test results, otice of accidets ad violece) ad assistace to a Joit Health ad Safety Committee (JHSC) i performig its fuctios. See Occupatioal Health ad Safety Act (OHSA) Sec. 9 (18) (d-f), 25 (2) (e) (l) (m), Get iformatio from the employer ad use it to: Covice the employer to prevet recurreces. Develop ad support JHSC recommedatios for improvemet. Share with the MOL. Support a grievace/remedy ad or appeal of MOL decisio. Use the questioaire o the ext pages to guide, ot dictate, your fact fidig. Ay iformatio you ca acquire will udoubtedly help you uderstad ad credibly advocate for improvemet, eforcemet ad appropriate appeal fidigs. Iformatio to gather followig a icidet or threat of workplace violece: 1. Who was ivolved? Record ame/positio, address/ locatio ad impact icidet. 2. Iterview above separately, ad ask from their poit of view: What happeed? Where? Whe? How? Describe the icidet ad ay circumstaces leadig to icidet i detail, apped ay supportig documets, e.g. WSIB Form Why did it happe? Whe iterviewig ay witesses, list ay factors that may have cotributed to the threat or icidet, e.g. high patiet acuity, icreased patiet populatio, uderstaffig, lack of security, overcrowdig, ot eough metal health beds, etc. 1

2 Get the Evidece to Support Eforcemet ad Appeals Probe prior icidets, ear misses, cocers: 1. Have similar icidets happeed or cocers bee raised? What happeed? Where? Whe? How? Who was ivolved? Obtai ad apped ay supportig documets, e.g. WSIB form 7, icidet reports. Probe adequacy of Violece Prevetio Program (Measures/Procedures/Equipmet/Traiig): 1. Ask workers what they thik the employer eeds to put i place (e.g. cotrols, procedures, staff, security etc.) that would better protect you ad your co-workers from actual workplace violece or threats of workplace violece from a particular patiet or patiets, etc., with a history of violet behavior. Additioal questios to ask members to determie what cotrols, procedures ad traiig may be lackig ad eeded. 1. Does your employer require you to call a Code White if you are experiecig workplace violece? 2. Does the Code White system work effectively ad do workers respod quickly? If ot why ot? 3. What measures could your employer purchase or put i place to esure you have a adequate meas to summo immediate assistace if you are beig attacked, stragled ad beate, ad caot call for help o a telephoe? 2

3 Get the Evidece to Support Eforcemet ad Appeals 4. Does your employer provide workers with persoal paic alarms liked to security? 5. What type ad brad of persoal alarms, if ay, are provided to staff ad how does that system work? a) Do they fuctio well? b) Are there ay dead zoes? 6 Were all staff ivolved i the icidet wearig their alarms? If ot why ot? 7. If it s just a screamer alarm do staff always atted whe they hear the oise, if ot why ot? 8. Do you have ay cocers with applyig physical restraits? If so what cocers? 9. Do you have ay cocers applyig mechaical restraits? 10. Did the assault happe whe puttig o or takig off restraits? 11. Were there ay sigs of escalatig behaviour before the assault? 12. If so what was doe or requested to your supervisor to miimize the risk to workers? 13. Was there ay reaso why a restrait was ot applied sooer if there were sigs of escalatio/ aggressio? 3

4 Get the Evidece to Support Eforcemet ad Appeals 14. Have you ever received itesive traiig o proper use ad safe applicatio of physical ad mechaical restraits? If so whe? 15. Does the employer s restraits procedure also cotai measures ad procedures for workers o how to protect themselves whe applyig or removig restraits (e.g. spit guards, gloves to prevet bites from pucturig the ski, a algorithm of whe it is safe to remove a restrait from a aggressive patiet)? 16. Did workers receive ay hads-o traiig for: idetifyig escalatig behaviours/triggers; de-escalatio techiques; self defese ad techiques to break free; safe take dow of a patiet or to deal with weapos or sharp-edged objects; how to safely apply restraits ad kow about restrait expiry dates? 17. Have you take Crisis Prevetio Istitute (CPI) ad/or ay other o-crisis violet itervetio traiig? If so, how may hours of traiig have you received? 18. Do you feel competet after takig CPI or other Noviolet Crisis Itervetio Traiig (NCIT) traiig that you have the skills ad ability to protect yourself or break free ad safely take dow a patiet durig a assault o you or a worker? 4

5 Get the Evidece to Support Eforcemet ad Appeals 19. Does your employer have a system i place that ca both electroically ad visually alert all staff at risk of a perso with a history of violet behaviour (e.g. wrist bads, sigage for doors, e-alerts with triggers ad behaviours o chart)? 20. Did the patiet who assaulted or threateed a worker have a history of violece? 21. Was that history made kow to the workers who were ivolved i the assault or the threat ad to all workers who may have come i cotact with the patiet before providig care to the patiet? 22. Does a otificatio of some sort come up o a computer scree whe the patiet is registered if previously violet or flagged? 23. Does the patiet s chart also easily idetify a flagged patiet ad their triggers or is the iformatio buried i a chart? 24. Does a flag stay o a patiet s record upo discharge? 25. Was patiet with a kow history of violece i a locked seclusio room? If ot why ot? 26. Should the patiet have had privileges? If ot why ot? 5

6 Get the Evidece to Support Eforcemet ad Appeals 27. Based o patiet acuity ad populatio does your employer have adequately traied security guards ad adequate umbers of security guards who respod to all Code Whites ad ca work with the care team ad place their hads o a patiet? 28. Will your employer place 24/7 security guards o the uit or i frot of the patiet s door if eed be to protect workers? 29. Would havig 24/7 security o the uit better help protect workers? 30. Did security respod i this latest situatio? If ot why ot? What broke dow? 31. Was the level of acuity of the patiets higher i the uit that shift ad why? 32. Whe the patiet came through emergecy was the uit overcesed; please explai ad by how may patiets. 33. Was the uit uderstaffed i ay way (sick calls ot replaced or staffig ot icreased whe there is a icrease i acuity ad/or patiet populatio, flow, icrease i violet behaviours, etc.)? 34. Was the uit fully staffed the shift before the acuity or populatio icreased? 6

7 Get the Evidece to Support Eforcemet ad Appeals 35. Did ay workers advise the maager that there was a icrease i patiet acuity, populatio, flow, behaviours that is creatig a risk to worker safety? 36. Did ayoe ask the maager to icrease staffig levels or icrease # of security guards because of worker safety cocers? 37. Did the maager do so, if ot, why ot? What was the ame of the maager who was cotacted to protect staff? 38. Does the employer have a surge procedure to icrease staff ad security guards that staff ca follow whe there is a icrease i patiet acuity, populatio (cesus) or flow? 39. Did physicias or psychiatrists write adequate orders i your opiio to address patiet behaviours? Please explai? 40. Is there a process i place where your maager will reassess the risk to worker safety whe the patiet acuity, populatio, flow, behaviours icrease or the uit is short staffed? If so does the JHSC get copies of all risk assessmet reports? 41. Did workers report ay cocers to the maager before or after the assault? Did maager respod quickly ad take ay steps to protect workers? If so what steps? 7

8 Get the Evidece to Support Eforcemet ad Appeals 42. Are workers aware of the employer s requiremets for workers to report all workplace icidets (icludig workplace violece) ad accidets ad illesses? 43. Did workers receive traiig o ad did they feel competet to uderstad the employers writte procedures o: a. Reportig all icidets of workplace violece. b. The employer s flaggig system. c. The restraits procedure/policy icludig whe to safely remove a restrait ad protect workers. d. Ay surge procedure/policy. e. Ay staffig measures ad procedures. f. Persoal alarms (whe to use, how to use, how to test, how to replace, how to reset, etc.), ad ay procedures o summoig immediate assistace. g. Security procedures (roles ad resposibilities, whe to call, how to call, whe to get additioal security, etc.) h. Formig a patiet, etc. Provicial Office 85 Greville St., Ste. 400, Toroto ON M5S 3A2 Tel: (416) Toll-free: Fax: (416) website: 8 Copyright 2015 Otario Nurses Associatio

Complaint form. Helpline:

Complaint form. Helpline: Helplie: 0161 923 6602 1 Complait form The quickest ad easiest way to complai about a doctor is to use our olie form at www.gmc-uk.org/complait. Whe you submit your complait olie, we will email you with