Prevention of occupational violence and aggression

Prevention of occupational violence and aggression 1. Introduction The Australian Nursing & Midwifery Federation (Victorian Branch) [ANMF (Vic Branch)] believes that occupational violence and aggression is not acceptable in any workplace, and that all members 1 have a right to work without being subjected to violence and aggression. Further, ANMF (Vic Branch) believes that occupational violence and aggression is an occupational health and safety (OHS) issue, which should be addressed as per other OHS issues, beginning with prevention through a risk management framework. 2. Objective The objective of this policy is to clarify the expectations of the ANMF (Vic Branch) regarding the prevention and management of risks to the health and safety of its members as a result of occupational violence and aggression. 3. Scope The policy applies to all members of the ANMF (Vic Branch). This policy focuses on violence and aggression perpetrated by patients 2, patients relatives or other visitors to the workplace. It is also potentially relevant in relation to violence perpetrated by intruders to the workplace. 4. Definitions Occupational violence and aggression Any incident where an employee is abused, threatened or assaulted in circumstances arising out of, or in the course of, their employment. Within this definition: Threat means a statement or behaviour that causes a person to believe they are in danger of being physically attacked. It may involve an actual or implied threat to safety, health or wellbeing; and Physical attack means the direct or indirect application of force by a person to the body of, clothing or equipment worn by, another person, where that application creates a risk to health and safety. Neither intent nor ability to carry out the threat is relevant. The key issue is that the behaviour creates a risk to health and safety. 1 Members refers to nurses, midwives and personal care workers 2 The word patient in this policy is interchangeable with the words client and resident as is appropriate for the clinical setting Australian Nursing and Midwifery Federation (Victorian Branch) Page 1 of 5 Policy statement - Adopted December 2001

Examples of occupational violence and aggression include, but are not limited to, verbal, physical or psychological abuse, punching, scratching, biting, grabbing, pushing, threats, attack with a weapon, throwing objects/furniture, sexual harassment or assault and any form of indecent physical contact. 3 Code black A hospital-wide internal security response to actual or potential aggression involving a weapon or a serious threat to personal safety 4 (Australian Standard 4083--2010 Planning for emergencies - Health care facilities) Code grey A hospital-wide co-ordinated clinical and security response to actual or potential aggression or violence (unarmed threat). Code Grey activates an internal alert or emergency response. 5 A Code Grey response also allows an intervention to occur in a situation where there is potential for violence or escalation, prior to any violence occurring, and is considered to be a preventative, proactive response to the threat of violence or aggression by a person towards themselves, other patients, staff members or visitors. Planned code grey a hospital-wide co-ordinated clinical and security response to anticipated risk of aggression or violence (unarmed threat) ie, prior to a situation where it can be anticipated that there may be a risk of violence or aggression. This is a pro-active, prevention response elicited PRIOR to any actual risk of violence or aggression. 5. Policy The ANMF (Vic Branch) policy is that: 5.1. All employees have a right to perform their work in an environment that is safe and without risk to health from occupational violence and aggression. 5.2. Occupational violence and aggression is not part of the job for members and it is critical that leaders such as government departments (eg Department of Health) and healthcare employers actively demonstrate their commitment to occupational violence and aggression prevention in the healthcare environment. 5.3. Occupational violence and aggression, like other occupational health and safety hazards, is most effectively addressed by prevention at the source. Therefore, determining the sources and causes of, and contributing factors to, occupational violence and aggression provides the best opportunity to prevent incidents. 5.4. Healthcare employers must establish and maintain an effective occupational violence and aggression prevention and management program which targets the multi-factorial nature of this hazard, and addresses potential contributing factors. 3 VWA guidance publication A Handbook for workplaces Prevention and management of aggression in health services, June 2008, page 2. 4 Department of Health, Better responses, safer hospitals Standards for Code Grey responses, accessed 25 August 2014, http://docs.health.vic.gov.au/docs/doc/d8c0e089893fd00fca257ced0081dba6/$file/code%20grey%20standards_may %202014.pdf 5 Department of Health, Better responses, safer hospitals Standards for Code Grey responses, accessed 25 August 2014, http://docs.health.vic.gov.au/docs/doc/d8c0e089893fd00fca257ced0081dba6/$file/code%20grey%20standards_may %202014.pdf Australian Nursing and Midwifery Federation (Victorian Branch) Page 2 of 5 Policy statement - Adopted December 2001

5.5. Healthcare employers should establish a work culture which actively encourages and supports formal reporting and investigation of all incidents involving occupational violence and aggression as an occupational health and safety incident, in addition to clinical incident reporting, where appropriate. 5.6. A collaborative approach is required between all parties, that is ANMF (Vic Branch), health care employers and their associations, other professionals who work in health settings, the Department of Health, Victoria Police, Victorian WorkCover Authority and the Department of Justice, for effective prevention and management of occupational violence and aggression. 5.7. Statistical data on the occurrence of occupational violence and aggression incidents must be collected and maintained by healthcare employers, Department of Health, Victorian WorkCover Authority and Victoria Police to assist with the development of future policies, codes, standards and guidelines. This data must be analysed and used in the development and implementation of future systemic preventative actions for occupational violence and aggression. 6. Key elements 6.1 Risk management approach a systems approach to the prevention of occupational violence ANMF (Vic Branch) supports the implementation of a systematic, risk management approach to preventing and responding to the risks associated with occupational violence and aggression, in consultation with Health and Safety Representatives. This involves: (a) Identifying precursors to, and risk factors associated with, occupational violence and aggression, including gaps in the implementation of the 10-pronged prevention strategy framework 6 : i. Legislation, policies, procedures and work practices, including Code Grey and Code Black ii. Identification of contributing factors, clinical or otherwise, via clinical preadmission / admission risk assessments for all patients and / or clients iii. Development of clinically-based management and / or care plans in consultation with all stakeholders, including treating healthcare workers, family and others iv. Security v. Education and training vi. Cross disciplinary understanding, communication and consistency of approach vii. Workplace culture, and the empowerment of staff viii. Workplace design ix. Incident reporting, investigation, review and feedback x. Post-incident support. (b) (c) (d) Assessing risks to members of occupational violence or aggression to determine how the hazard can most effectively be eliminated or controlled. Eliminating or controlling risks of occupational violence and aggression through risk control measures which focus on the source of the factors that cause or contribute to occupational violence and aggression or, if that is not reasonably practicable, implementing measures that reduce the risk. Risk control measures should address the causes where possible, and should consider (but not be limited to) the hazards identified. 6 Chrisfield, Kathryn as detailed in Needham et al, 2014, Fourth International Conference on Violence in the Health Sector, pages 444-447 Australian Nursing and Midwifery Federation (Victorian Branch) Page 3 of 5 Policy statement - Adopted December 2001

6.2 Consultation and representation a) The participation of, and consultation with, staff and their representatives, including ANMF (Vic Branch) and Health & Safety Representatives (HSRs), is critical to the effective implementation of relevant and sustainable control strategies for preventing and responding to the risks associated with occupational violence and aggression. b) Appropriate consultative and representative structures (including HSRs and OHS committees) are necessary so as to encourage staff to report incidents resulting from occupational violence and aggression to both management and / or HSRs. 7. References This policy should be read in conjunction with the following ANMF (Vic Branch) policies relating to OHS: ANMF (Vic Branch) s Occupational Health and Safety Policy Other references include: Chrisfield, K 2014, A 10-pronged approach to the prevention of occupational violence against health workers, in Needham I, Kingma M, McKenna K, Frank O, Tuttas C, Kingma S & Oud N, Fourth International Conference on Violence in the health Sector Towards safety, security and wellbeing for all, Kavanah, The Netherlands, pp. 444-447 Department of Health 2014, Better responses, safer hospitals Standards for Code Grey responses, accessed 14 August 2014, <http://docs.health.vic.gov.au/docs/doc/d8c0e089893fd00fca257ced0081dba6/$file/code%20g rey%20standards_may%202014.pdf> Department of Health 2011, Preventing occupational violence - A policy framework including principles for managing weapons in Victorian health services December 2011, available at <http://www.health.vic.gov.au/ data/assets/pdf_file/0006/680937/preventing-occupationalviolence.pdf> Department of Human Services 2005, Occupational violence in nursing: An analysis of the phenomenon of Code Grey/Black events in four Victorian hospitals February 2005, DHS, Melbourne Department of Human Services 2005, Victorian Taskforce on Violence in Nursing Final Report November 2005, DHS, Melbourne Parliament of Victoria, 2012, Inquiry into Violence and Security Arrangements in Victorian Hospitals December 2011, Government Printer for State of Victoria, Melbourne Standards Australia 2010, Planning for Emergencies Health Care Facilities, AS 4083 2010, viewed 14 August 2014, SAI Global database Standards Australia 1997, Security for Health Care Facilities Part 1 General Requirements, AS 4485.1 1997, viewed 14 August 2014, SAI Global database Standards Australia 1997, Security for Health Care Facilities Part 2 Procedures Guide, AS 4485.2 1997, viewed 14 August 2014, SAI Global database Australian Nursing and Midwifery Federation (Victorian Branch) Page 4 of 5 Policy statement - Adopted December 2001

WorkSafe Victoria 2008, A Handbook for workplaces Prevention and management of aggression in health services, 1 st Edition, June 2008, accessed 14 August 2014 via the VWA website, <http://www.vwa.vic.gov.au/forms-and-publications/forms-and-publications/prevention-andmanagement-of-aggression-in-health-services-a-handbook-for-workplaces> WorkSafe Victoria 2010, A Toolkit for workplaces - Prevention and management of aggression in health services, 1 st Edition - April 2010 (these checklist tools are in the handbook but are also available separately in a Word version that can be adapted and downloaded from VWA s website refer to <http://www.vwa.vic.gov.au/> WorkSafe Victoria 2006, Working Safely in Visiting Health Services (refer to checklist) 1 st Edition, June 2006, accessed 14 August 2014, <http://www.vwa.vic.gov.au/ data/assets/pdf_file/0005/9527/working_safely_in_visiting_health _Services_-_Web.pdf> 8. Relevant legislation Reference should be made to: Occupational Health and Safety Act 2004 Occupational Health and Safety Regulations 2007 Sentencing Amendment (Emergency Workers) Act 2014 Justice Legislation Amendment (Confiscation and other matters) Act 2014 For further information, please contact the Occupational Health and Safety Unit of the ANMF (Vic Branch) Office, Telephone (03) 9275 9333. Australian Nursing and Midwifery Federation (Victorian Branch) Page 5 of 5 Policy statement - Adopted December 2001