Occupational Health and Safety (OHS) Policy Document Number # QH-PCD-275-6-2:2012 Procedure for Occupational Violence Prevention Training State-wide Distribution Custodian/Review Officer: Director, Safety and Wellbeing Version no: 1.0 1. Purpose This Procedure describes the processes for consistent application of Occupational Violence Prevention Training across Queensland Health. Applicable To: All Queensland Health staff. Approval Date: 01/07/2012 Effective Date: 01/07/2012 Next Review Date: 01/05/2015 Authority: Lyn Rowland, Chief Human Resources Officer, System Support Services Division Approving Officer Lyn Rowland Chief Human Resources Officer, System Support Services Division Supersedes: 2-60#38 Occupational Violence Prevention Training Key Words: OVP, training, risk management, ABM, training needs, security, refresher, qualification, deescalation, fitness, simulation Accreditation References: EQuIP5: 3.2 National Safety and Quality Health Services Standards: 1.4.1; 1.4.2; 1.4.3; 1.4.4 National Standards for Mental Health Services: Standard 2 - Safety 2. Scope This Procedure relates to all Queensland Health employees (permanent, temporary and casual) and all organisations and individuals acting as its agents (including Visiting Medical Officers and other partners, contractors, consultants and volunteers). 3. Supporting documents Authorising Policy and Standard/s: OHS Policy Implementation Standard for Occupational Violence Prevention and Management Protocols, Procedures, Guidelines Occupational Violence Risk Assessment Procedure Occupational Violence Prevention Risk Assessment Tool Guideline Occupational Violence Prevention Staff Survey Guideline Occupational Violence Prevention Training Program: Aggressive Behaviour Management De-Escalation Guideline Version No: 1.0 - Effective From: 01 July 2012 Page 1 of 8
Occupational Violence Prevention Training Program: Aggressive Behaviour Management Awareness Guideline Occupational Violence Prevention Training Program: Aggressive Behaviour Management Basic Personal Safety Guideline Occupational Violence Prevention Training Program: Aggressive Behaviour Management Orientation Guideline Queensland Health Aggressive Behaviour Management for Healthcare Workers Participant Manual Guideline Queensland Health Aggressive Behaviour Management for Healthcare Workers Instructor Manual Guideline What To Do If I Am Assaulted at Work Brochure Guideline Forms and templates Occupational Violence Risk Assessment Tool Occupational Violence Prevention Staff Survey 4. Related documents Work Health and Safety Act 2011, Queensland Government Work Health and Safety Regulation 2011, Queensland Government How to Manage Work Health and Safety Risks, Code of Practice 2011, Workplace Health and Safety Queensland Hazardous Manual Tasks, Code of Practice 2011, Workplace Health and Safety Queensland Integrated Risk Management Policy (No 13355) and associated standards (Queensland Health Risk) AS/NZS 4801:2001 Occupational Health and Safety Management Systems - Specification with Guidance for Use AS/NZS ISO 31000:2009 Risk Management- Principles and Guidelines OHSMS 2#21 Queensland Health Occupational Health and Safety Policy Prevention and Management of Aggression in Health Services, December 2009, Workplace Health and safety Queensland 5. Procedure for Occupational Violence Prevention Training 5.1 Approved Occupational Violence Prevention Course 5.1.1 The corporately approved training course is the Queensland Health owned Aggressive Behaviour Management (ABM) for Healthcare Workers course. The ABM course is a nationally accredited competency course based on the principles of early intervention, prevention, de-escalation and avoidance. Use of force Version No: 1.0 - Effective From: 01 July 2012 Page 2 of 8
principles are explained and developed from theory to practice to provide guidance for participants of acceptable behaviours relevant to circumstances in keeping with HR Policy E3 Assault in the Workplace. Use of force expectations are of a graduated model with an emphasis on de-escalation and negotiation. The package is research based, defensible in court and in episodes of team restraints relies on a minimum of three person teams. The ABM training course is designed as a progressive pathway of units (as outlined in Attachment A), from the 30900QLD Certificate III Aggressive Behaviour Management qualification. The course addresses theoretical and practical skills at different levels dependant upon the assessed training needs of the work area, the role and tasks that different staff perform. Untrained staff, including contractors and agency staff, must be provided with adequate information and supervision to ensure work practices. 5.1.2 The course addresses theoretical and practical skills at different levels dependant upon the assessed training needs of the work area, the role and tasks that different staff perform. 5.1.3 Flexible options in the delivery of training may be utilised including sequential attendance by staff attending training one day per week over a period to complete the course. The maximum interval between attendances shall be no greater than six months. 5.1.4 Alterations to ABM program duration and delivery mode shall be authorised by the Occupational Health and Safety (OHS) Steering Committee (for example, the development of electronic learning alternatives). For further information regarding the approved occupational violence prevention course please refer to Attachment C. 5.2 Training Needs 5.2.1 All new staff identified as requiring occupational violence prevention training shall attend an orientation program on occupational violence awareness, delivered by OHS Practitioner/s or ABM Instructor/s, by use of the Occupational Violence Prevention (OVP) training Orientation Module. The module, which is outlined in the OVP Training Program: ABM Orientation Guideline, shall include general principles regarding occupational violence prevention and responses. 5.2.2 Minimum training requirements for staff shall include: training is provided to staff based on the findings of the Occupational Violence Risk Assessment Procedure. workplaces and functions assessed as a high risk of physical violence following Occupational Violence Risk Assessment Procedure shall implement training to the level of ABM Basic Personal Safety. For example, Accident and Emergency Departments, Mental Health Inpatient Units and Queensland Health Safety and Security Officers work areas assessed as requiring identified staff to perform physical restraint of patients shall implement ABM Team Restrictive Practices for those identified staff. Staff, who have not completed or have been found Not Yet Competent (NYC) in ABM Team Restrictive Practices, shall not perform restraint. Version No: 1.0 - Effective From: 01 July 2012 Page 3 of 8
5.2.3 Re-assessment of competency and refresher training shall be provided to staff, including: changing work location or practices returning to work following an extended absence (e.g. maternity leave or due to injury/illness) on an annual basis to maintain competencies in areas assessed as a high risk of physical violence. 5.2.4 Training records, including training dates, content, participant details, participant/trainer signatures and level of competency achieved shall be documented appropriately to ensure a structured system for tracking staff competency and annual refresher training. 5.3 Orientation and Induction All new staff identified as requiring ABM training shall attend an orientation program on occupational violence awareness, delivered by OHS Practitioner/s or ABM Instructor/s, which shall include: general principles regarding occupational violence prevention and responses local methods of arranging attendance at the required level of ABM training Occupational Violence Prevention Training Program: Aggressive Behaviour Management Orientation Guideline, DVD Resource 5.5 Linkage to Performance Appraisal and Development Process 5.5.1 Staff attending Basic Personal Safety, Restrictive Practices and Team Restrictive Practices shall complete ABM training, to the assessed level of occupational violence risk in specific workplaces, annually and this requirement shall be included in their performance appraisal and development. 5.5.2 Training targets: All new employees: 100% of staff attending Orientation/Induction Employees assessed at a level of Awareness training only; Employees assessed at a level of Verbal De-escalation training; and Employees assessed at a level of Basic Personal Safety, Restrictive Practices training: Attendance shall be provided to staff based on findings of Procedure for Occupational Violence Risk Assessment Work. Employees assessed at a level of Team Restrictive Practices training: 100% of staff assigned to the role of restraint such as Code Black response team. Safety and Security Employees: 100% of full time and casual officers to the level of Team Restrictive Practices with additional annual training and competency testing in alignment with Personal Protective Devices - Possession and Use of Guideline. 5.6 Aggressive Behaviour Management Training Qualification Requirements 5.6.1 Awareness level training may be delivered by either ABM Instructors or other endorsed staff who have completed the ABM Awareness Facilitation program authorised by the Occupational Violence Prevention Team. 5.6.2 Staff in this role shall: have completed ABM Awareness prior to on-delivery Version No: 1.0 - Effective From: 01 July 2012 Page 4 of 8
hold TAE40110 Certificate IV Training and Assessment or act under direct supervision of a TAE40110 Certificate IV holder who holds Certificate III in Aggressive Behaviour Management; (relevant units are included in ABM Instructor training 30901QLD) deliver training in a planned manner under the supervision of local Health Service/Divisional ABM Coordinators. 5.6.3 Training and assessment of verbal de-escalation, basic personal safety, restraint techniques and safe team restraint shall be conducted by qualified ABM Instructors using the Queensland Health endorsed training package, ABM. 5.6.4 Training will be delivered in accordance with ABM for Healthcare Workers Instructors Manual Guideline. 5.6.5 Initial qualification of Instructors shall be by successful completion of the ABM Instructor training course. Qualifications issued are: 30900QLD Certificate III in Aggressive Behaviour Management (Healthcare Worker) 30901QLD Certificate IV in Aggressive Behaviour Management Instructor to maintain ABM Instructor qualifications, reassessment is conducted biennially; and issue of Certificate III competency to staff satisfactorily completing ABM training is limited to ABM Instructors holding TAE40110 Certificate IV in Training and Assessment. 5.6.6 The qualification of ABM Safety Officer (30900QLD Certificate III Safety Officer, an Assistant Instructor with a prerequisite completion of 30901QLD Certificate III Aggressive Behaviour Management) with biennial reassessment may support the delivery of physical skills training during physical skills simulation scenarios as a role-player or safety officer. 5.6.7 A secondary qualification of Defensive Tactics Instructor (DTI) is available for ABM Instructors with biannual reassessment to deliver and assess Queensland Health Safety and Security Officers in alignment with Personal Protective Devices Safe Possession and Use of Guideline. 5.6.8 Staff in the DTI role shall hold TAE40110 Certificate IV in Training and Assessment. 5.6.9 Audit and evaluation of ABM training activity is conducted by the Queensland Health OHS Steering Committee s Occupational Violence Prevention Team. 5.7 Recognition of Current Competency and Recognition of Prior Learning 5.7.1 ABM Instructors holding TAE40110 Certificate IV in Training and Assessment are authorised under the Australian Qualifications Framework to grant competency through full or partial recognition of current competency and recognition of prior learning. 5.7.2 Qualifications sought for recognition of prior learning should have details of the: learning outcome competencies achieved date of achievement name of organisation issuing the qualification. 5.8 Staff Fitness for Attending Training Version No: 1.0 - Effective From: 01 July 2012 Page 5 of 8
5.8.1 Concerns regarding employee fitness shall be identified with the relevant line manager. 5.8.2 At the completion of training staff shall be assessed as having attended, being competent or not yet competent (NYC) with this information recorded on a competency feedback form. 5.8.3 Copies of the competency shall be forwarded to the staff member and relevant line manager and held in each Health Service/Division ABM training register/electronic record. 5.8.4 Should a staff member be found NYC, a reasonable time span to allow return for retraining or retesting shall be allowed. 5.8.5 Concerns such as previous or current injuries, disabilities or related medical conditions regarding staff member s ability to complete with competency shall be referred for investigation and an assessment by a more appropriate medical expert. 5.8.6 This may result in a number of staff who shall not be expected to take part in a restraint or team takedown and would be expected to assume other duties during that time (examples being administering medication, communicating as required or assisting with other patients/relatives). 5.9 Instructor Student Ratio 5.9.1 Safety is paramount during training, and a detailed safety and role play briefing shall be conducted prior to the commencement of all physical training sessions. 5.9.2 Staff shall follow the directions of the Instructor when participating in simulation training utilising provided personal protective equipment. For further details refer to Attachment B. 5.10 Dynamic Simulation Training and Physical Requirements of Students 5.10.1 Dynamic simulation by scenario of occupational violence is utilised within safety parameters to replicate violent incidents. 5.10.2 Clear safety guidelines and equipment shall be provided for all physical components of training. 5.10.3 Participants are not compelled to participate and may elect to observe other participants. Participants who elect to observe shall not be assessed as competent. If a staff member is found to be NYC, post training, a reasonable time span to allow return for retraining or retesting shall be allowed. Concerns regarding ability to complete a competency should be referred for investigation and an assessment by a more appropriate medical expert. Under obligations of OHS legislation all employees allocated to a workplace with an exposure to occupational violence will not be exposed to the risk without protective strategies being in place. If competency can not be reached by a staff member, a Human Resources approach should be considered by line management with options such as reasonable adjustment. 5.10.4 Due to the physical nature of simulation training, employees shall declare on the medical declaration section of the Course Registration Form any previous or current Version No: 1.0 - Effective From: 01 July 2012 Page 6 of 8
injuries, disabilities or related medical conditions. This will enable instructors to take measures to reasonably and safely accommodate staff during the training. 6. Definition of Terms Term Definition / Explanation / Details Source Employee Fitness Induction Occupational Violence Prevention Team Occupational and Behaviour Orientation Violence Aggressive Training Instruction and Information Concerns regarding employee fitness will be identified with the relevant line manager. Queensland Health has established processes in regard to return to work or rehabilitation procedures and Human Resources Policy G3 Reasonable Adjustment. Due to the physical nature of simulation training, employees must declare on the medical declaration section of the course registration form any previous or current injuries, disabilities or related medical conditions. This will enable instructors to take measures to reasonably and safely accommodate staff during the training. Is the process by which employees are familiarised with their new immediate work unit and environment, including policies, standards, safe work procedures, and training in relevant systems. It also includes some mandatory training. Some topics may be common to orientation and induction, requiring both local and broader application. Is the Queensland Health Occupational Health and Safety Steering Committee s program team addressing the risk exposure of occupational violence. The team consists of the Principal and Senior Occupational Health and Safety Consultants. Any incident in which employees are abused, threatened or assaulted in circumstances arising out of, or in the course of their employment. Incidents include verbal, physical or psychological abuse, threats or other intimidating behaviours, intentional physical attacks, aggravated assault, threats with an offensive weapon, sexual harassment and sexual assault. The three month staged process by which new employees are welcomed and introduced to their Hospital and Health Service/Division and Queensland Health. This includes the mission, strategic objectives, structure and scope of operations and incorporates much of mandatory training. Train your workers in the work procedure to ensure that they are able to perform the task safely. Training should require workers to demonstrate that they are competent in performing the task according to the procedure. It is insufficient to simply give a worker the procedure and ask them to acknowledge that they understand and are able to perform it. Training, instruction and information must be provided in a form that can be understood by all workers. Information and instruction may also need to be provided to others who enter the workplace, such Internal documentation, Safety and Wellbeing Unit, Occupational Violence Prevention Queensland Health Human Resources Policy G6 Induction and Orientation Aggressive Behaviour Management for Healthcare Workers, Queensland Health Aggressive Behaviour Management for Healthcare Workers, Queensland Health Queensland Health Human Resources Policy G6 Induction and Orientation How to Manage Work Health and Safety Risks, Code of Practice 2011, Workplace Health and Safety Queensland Version No: 1.0 - Effective From: 01 July 2012 Page 7 of 8
Up-to-date training and competency as customers or visitors. Control measures, particularly lower level controls, depend on all workers and supervisors having the appropriate competencies to do the job safely. Training should be provided to maintain competencies and to ensure new workers are capable of working safely. How to Manage Work Health and Safety Risks, Code of Practice 2011, Workplace Health and Safety Queensland 7. References and Suggested Reading Prevention and Management of Aggression in Health Services, December 2009, Workplace Health and Safety Queensland 8. Consultation (optional) Key stakeholders (position and business area) who reviewed this version are: Principal OHS Consultant, OVP Principal OHS Officer, Safety and Wellbeing Principal Policy Officer, Planning and Performance 9. Procedure Revision and Approval History Version No. Modified by Amendments authorised by Approved by 1.0 Garth Richards, Principal OHS Consultant, OVP L O Neill, Principal OHS Officer, Safety and Wellbeing Graham Easterby, a/director, Safety and Wellbeing, System Support Services Division Lyn Rowland, Chief Human Resources Officer, System Support Services Division Version No: 1.0 - Effective From: 01 July 2012 Page 8 of 8
Attachment A Aggressive Behaviour Management Training Program This document serves as a guideline only; levels of training should be supported by the determination of Occupational Violence Risk Assessment as per Procedure for Occupational Violence Risk Assessment. The characteristics of different workplaces will present differing levels of risk, change in risk profile may increase or decrease training attendance. Alternative controls other than training may mitigate the level of risk within workplaces see Implementation Standard for Occupational Violence Prevention and Management and Procedure for Occupational Violence Risk Assessment for alternative control strategies. Aggressive Behaviour Management Training Structure Occupational Violence Orientation (single attendance no annual refresher) and should be conducted for all staff within three months of commencement in alignment with HR Policy G6; Occupational Violence Awareness (8 hrs) (single attendance no annual refresher) attendance provided to staff based on findings of Procedure for Occupational Violence Risk Assessment. Training is specific to the workers role and task performed; Verbal De-escalation (8 hrs) (single attendance no annual refresher) attendance provided to staff based on findings of Procedure for Occupational Violence Risk Assessment. Training is specific to the workers role and task performed; Basic Personal Safety (8 hrs) (annual refresher 8 hrs) attendance provided to staff based on findings of Procedure for Occupational Violence Risk Assessment Work Practice Directive. Training is specific to the workers role and task performed; Restrictive Practices (8 hrs) (annual refresher 4 hrs) attendance provided to staff based on findings of Procedure for Occupational Violence Risk Assessment. Training is specific to the workers role and task performed; Team Restrictive Practices (8 hrs) (annual refresher 4 hrs) attendance dependant on task requirement of role or work unit) provided to staff based on findings of Procedure for Occupational Violence Risk Assessment. Training is specific to the workers role and task performed delivered to all employees assigned the role of restraint such as Code Black response teams; Version No: 1.0 - Effective From: 01 July 2012 Page 1 of 2 Printed copies are uncontrolled
Attachment A Safety and Security Officer (8 16 hrs) dependant on endorsed Health Service District work practice guidelines in relation to safety and security functions and roles. Orientation General Attendance all staff Refer to detail of Procedure for Occupational Violence Risk Assessment Awareness Training Verbal Deescalation Training Basic Personal Safety Training Restrictive Practices, Team Restrictive Practices Risk based attendance following Occupational Violence Risk Assessment Tool Training needs analysis Safety and Security Officer Training Task Based attendance following OVRAT Training needs analysis Refresher Training Levels Basic Personal Restrictive Safety Refresher Practices 8 hour annually 4 hour annually plus Basic Personal Safety Refresher Team Restrictive Practices 4 hours annually plus Restrictive Practices Refresher and Basic Personal Safety Refresher 8 hours annually 12 hours annually 16 hours annually Safety and Security Officer Training 8 16 hours annually subject to requirements of Personal Protective Devices Use of Guideline plus Team Restrictive Practices Refresher, Restrictive Practices Refresher & Basic Personal Safety Refresher 16 to 32 hours annually Version No: 1.0 - Effective From: 01 July 2012 Page 2 of 2 Printed copies are uncontrolled
Attachment B Aggressive Behaviour Management Training Ratios During physical skills training the number of staff participating will be limited by: The safety parameters detailed in the Occupational Violence Prevention Training Program: Aggressive Behaviour Management for Healthcare Workers Instructor Manual Guideline Relevant physical constraints imposed by the size of individual training venues. Class ratios: Orientation: class size no limit (one ABM Instructor/Facilitator); Awareness: class size no limit (one ABM Instructor/Facilitator); Verbal De-escalation: limited to a ratio of 12 participants to one ABM Instructor; Basic Personal Safety: limited to a ratio of 12 participants to one Instructor (two ABM Instructors present with substitution of one Safety Officer during dynamic simulation component); Restrictive Practices training courses: limited to a ratio of 12 participants to two instructors (two ABM Instructors present with substitution of one Safety Officer) (three ABM Instructors present with substitution of one Safety Officer during dynamic simulation component); Safety and Security Officer: one ABM Instructor holding Defensive Tactics Instructor Qualifications; and Remote area exemption from class ratios may occur following a risk management framework in consultation with the Occupational Health and Safety Steering Committees Occupational Violence Prevention Team. Version No: 1.0 - Effective From: 01 July 2012 Page 1 of 1
Attachment C Occupational Violence Prevention Training Approved Occupational Violence Prevention Course Information The ABM course is a nationally accredited competency course based on the principles of early intervention, prevention, de-escalation and avoidance. Use of force principles are explained and developed from theory to practice to provide guidance for participants of acceptable behaviours relevant to circumstances in keeping with HR Policy Assault in the Workplace. Use of force expectations are of a graduated model with an emphasis on deescalation and negotiation. The package is research based, defensible in court and in episodes of team restraints relies on a minimum of three person teams. The ABM training course is designed as a progressive pathway of units (as outlined in Attachment A), from the 30900QLD Certificate III Aggressive Behaviour Management qualification. Competency Based Assessments 30554QLD Certificate III in Aggressive Behaviour Management consists of five core units (refer Attachment A) with a number of elective units. Students who complete individual units may be awarded a Statement of Attainment in units completed where assessment has taken place and they have demonstrated competency, in accordance with the Queensland Vocational Education, Training and Employment Act 2000. Completion of all five core units may lead to the awarding of the Certificate III qualification. Maintenance of the Certificate III qualification is reliant on annual recertification at refresher training. Training Targets All new employees Employees assessed at a level of Awareness training only Employees assessed at a level of Verbal De-escalation training 100% of staff attending Orientation Attendance provided to staff based on findings of Procedure for Occupational Violence Risk Assessment Attendance provided to staff based on findings of Procedure for Occupational Violence Risk Assessment Version No: 1.0 - Effective From: 01 July 2012 Page 1 of 2
Attachment C Employees assessed at a level of Basic Personal Safety, Restrictive Practices training Employees assessed at a level of Team Restrictive Practices training Safety and Security Employees Attendance provided to staff based on findings of Procedure for Occupational Violence Risk Assessment 100% of staff assigned to the role of restraint such as Code Black response team 100% of full time and casual officers to the level of Team Restrictive Practices with additional annual training and competency testing in alignment with Procedure for Personal Protective Devices - Safe Possession and Use Of Version No: 1.0 - Effective From: 01 July 2012 Page 2 of 2