North American Occupational Safety & Health Week May 6-12, 2012 Power Point Presentation and Speaker Notes Slide 1 Origin of North American Occupational Safety and Health Week NAOSH Week began in 1997 when Canada, USA and Mexico formed an agreement to dedicate one week a year to raise awareness about the importance of safety at work, at home, and in the community. Across the country NAOSH week events and activities are coordinated by local, provincial and regional committees, who share a focus and vision of safer work places. We are taking this opportunity to raise the awareness of Violence Prevention in our worksites. Slide 2 Impact of Violence in Healthcare Statistics from WorkSafeBC: 55% of all the violence claims in BC are from healthcare and social services 12-14% of nurses WCB claims result from incidents of workplace violence 86% of nurses have experienced verbal abuse Statistics from the BCNU Culture Report: 61% have experienced physical violence 96% of these types of violent acts are related to patient interactions. In addition to these facts, research shows that workplace incidents of violence in healthcare are under reported. It is estimated that the actual number of violent incidents is significantly higher. Every injured nurse off work impacts the provision of healthcare to the public. Slide 3 Definition of Violence This definition is from the Provincial Violence Prevention Steering Committee. Violence includes, yelling, swearing, violent threats, throwing objects, spitting, hitting, kicking, biting, etc. dg-cope/378 1
*Note to Speaker The Provincial Violence Prevention Steering Committee is a Committee with representation from each healthcare union, health authority, WorkSafeBC, HEABC (Health Employer s Association) and a representative of the Ministry of Health. They meet quarterly to discuss and plan violence prevention. Familiarize yourself with the OH&S Regulations for violence in the workplace under Section 4.27. Slide 4 Risk Assessment The OH&S Regulations require that an employer carry out a risk assessment whenever there is a risk of injury from violence. A risk assessment helps to determine appropriate organizational violence prevention measures. These form the basis of the violence prevention policy and procedures. Violence risk factors are any characteristics of a person, situation, or a person s environment that increases the likelihood that a violent incident may occur. What creates a risk of violence in your work or at your worksite? Examine the following to assess the risk in your work and workplace: Is there a task or activity of your job that puts you at increased risk of violence? These are activities that you do in your day to day work. Working alone Working in higher risk departments (e.g. emergency or mental health) Providing care to clients on the street Dispensing narcotics, Being in a client s personal space when providing direct care Is the risk caused by the physical design or layout of your worksite? Lack of protective barriers at workstations Poorly lit parking lots, High crime neighborhoods, Unrestricted access of the public to the workplace Lack of secure rooms for clients Sitting with your back to the door resulting in you being unable to see who enters your space or blocks your exit. dg-cope/378 2
Is the risk a patient or another person? A client with a history of violence A client with a mental illness or disease such as dementia, delirium, or someone with substance abuse issues A client with a communication or language barrier A client s perceived lack of control of in the current situation which could add stress to them and trigger a violent reaction. Is the risk a result of how your work is organized and supported (e.g. workload, staffing security)? Issues such as workload, under-staffing and delayed care can act as a trigger to violent events by clients and family. The lack of trained and available security also puts workers at risk. If you find any of these or other risks, report and document them according to your Employer s reporting system. Reporting methods vary from use of paper forms to report hazards and incidents, accessing call centers, on line reporting forms. Inform your Supervisor and BCNU OHS representative and work with them to eliminate or minimize the risk to prevent injury to workers. Slide 5 What can you do to prevent injury from violence? There are a number of ways to reduce risks of violence or prevent injury from violence including: Observe precautionary measures while you work Check for violence alert notifications, such as purple dots, purple arm bands, or electronic indicators. Conduct a point of care risk assessment before every client interaction and follow established safety interventions as described in the care plan. Follow other established safety interventions in your workplace such as wearing panic alarms and Code White procedures. Communicate what you know about violence risks and prevention measures Communicate information using violence alerts in care plans, kardex, white boards, safety huddles and shift reports. Remember to keep the information up to date and current to help keep other care providers informed (e.g. casual staff, dietary staff, housekeeping, and laboratory staff). dg-cope/378 3
Use appropriate reporting tools (report issues early) Document changes in patient behavours. Chart what you see and hear, do not use aggressive +++. Describe the behavior such as pacing, not making eye contact, clenching fists. Chart the exact verbal outbursts or language that you heard even if it is vulgar. If violent behaviours continue, discuss your concerns with your manager/supervisor right away and participate in revising the safety interventions on the care plan Report ALL incidents of violence, even if there is no injury. Inform your BCNU OHS Steward or Joint Occupational Health and Safety Committee representative of serious incidents. They can be of assistance in addressing ongoing violence. Respond to acts of violence You can attempt to de-escalate the situation. If the situation escalates safely remove yourself from the situation and get help by using your Employer s Code White procedure. Code White response may vary at workplaces. The response could be a fully trained and practiced advance team or co-workers as a show of support, or calling security or outside support like police or RCMP. Ask your Employer for specifics of Code White at your workplace. Remember, according to the WorkSafeBC Act, you have the right to refuse unsafe work *Note to Speaker Familiarize yourself with the OH&S Regulation 3.12 details for the process to follow when a worker refuses unsafe work. Slide 6 What to Do If a Violent Incident Happens 1. Notify your Supervisor/Manager about all incidents, even if there is no injury. This includes incidents that have the potential to cause harm. This is important in order to address the risk and prevent it from happening again and possibly causing injury. Inform your BCNU OH&S Steward or Joint OH&S representative of the incident. This will ensure that there is a follow up investigation, as required by the OH&S Regulations. 2. Seek first aid or medical care (if required) as soon as possible. Make sure you say that the incident happened at work. Tell your supervisor if you need to leave your work area. 3. Report the incident as soon as possible using the employee incident reporting system established at your workplace for employee incidents. This dg-cope/378 4
could be a call center, electronic or paper employee incident report form, even if there is no injury. Let the BCNU representative on the Joint OH&S Committee know of the incident. 4. Start a WCB claim for medical treatment and/or missed time from work. Complete a WorkSafe BC Form 6 on paper, online, or by phone. (www.worksafebc.com or 1-888-967-5377) 5. Participate in the incident investigation with your BCNU OH&S Steward or BCNU Joint OH&S representative who will be there to support you through the investigation. The investigation is never to lay blame on the worker; it is to find a means of preventing incidents from happening again. Slide 7 Seek Critical Stress Debriefing After a traumatic incident seek critical incident response and critical incident stress debriefing even if you think you do not need it. CISD can significantly reduce your chances of developing Post Traumatic Stress Disorder, if provided in a timely manner, optimally within 24-72 hours following the incident. Places to access CISD include your employer Workplace Health, the Employee and Family Assistance Program and WorksafeBC. Slide 8 Closing Remarks Violence is NOT Part of Your Job - Band-Aids are NOT Solutions! Be part of the action and contact your worksite BCNU OH&S Steward or BCNU Joint OH&S representative to participate in Safety & Health Week activities. Take the BCNU online quiz Health and Safety Week 2012 Violence Prevention Challenge and enter to win a prize at www.bcnu.org. *Note to Speaker Know your audience and refer them to who they can contact at their worksite. For more information about Safety & Health Week visit: http://www.naosh.ca dg-cope/378 5