State clearly to employees,
clients, and patients that violence is not permitted
Establish liaison with
local police and state prosecutors. Report all incidents of violence.
Provide police with physical layouts of facilities to expedite
Require employees to
report all assaults or threats to a supervisor or manager (e.g.,
can be confidential interview). Keep log books and reports of
such incidents to help in determining any necessary actions to
prevent similar occurrences.
Advise and assist employees,
if needed, of company procedures for requesting police assistance
or filing charges when assaulted.
support during emergencies. Respond promptly to all complaints.
Set up a trained response team to respond to emergencies.
Use properly trained
security officers, when necessary, to deal with aggressive behavior.
Follow written security procedures.
Provide sensitive and
timely information to persons waiting in line or in waiting rooms.
Adopt measures to decrease waiting time.
Establish a list of
"restricted visitors" for previous employees, relatives,
and patients with a history of violence. Copies should be available
at security checkpoints, nurses' stations, and visitor sign-in
areas. Review and revise visitor check systems, when necessary.
Limit information given to outsiders on hospitalized victims
and procedures for secured areas, and emergency evacuations,
and for monitoring high-risk area at night.
Treat and/or interview
aggressive or agitated clients in relatively open areas that
still maintain privacy and confidentiality (e.g., rooms with
Use case management
conferences with co-workers and supervisors to discuss ways to
effectively respond to potentially violent employees or patients.
plans to handle employees, clients, or patients who are "acting
out' or making verbal or physical attacks or threats. Consider
using certified employee assistance professionals (CEAPs) or
in-house social service or occupational health service staff
to help diffuse employee, client or patient.
from wearing jewelry to help prevent possible strangulation in
confrontational situations. Community workers should carry only
required identification and money.
the facility to remove tools or possessions left by visitors
or maintenance staff which could be used inappropriately by patients.
Provide staff with
identification badges, preferably without last names, to readily
from carrying keys, pens, or other items that could be used as
Provide staff members
with security escorts to parking areas in evening or late hours.
Parking areas should
be highly visible, well-lighted, and safely accessible to the
Use the "buddy
system," especially when personal safety may be threatened.
Encourage home health
care providers, social service workers, and others to avoid threatening
Staff should exercise
extra care in elevators, stairwells and unfamiliar locations.
Develop policies and
procedures covering work at remote/other worksites including
the refusal to provide services in a clearly hazardous situation.
Establish a daily work
plan for field workers to keep a designated Contact person informed
about workers' whereabouts throughout the workday. If an employee
does not report in, the Contact person should follow-up.
Conduct a comprehensive
post-incident evaluation, including psychological as well as
medical treatment, for employees who have been subjected to abusive
Ensure adequate and properly trained staff for restraining patients
Ensure adequate and qualified staff coverage at all times. Times
of greatest risk occur during patient transfers, emergency responses,
meal times, and at night. Locales with the greatest risk include
admission units and crisis or acute care units. Other risks include
admission of patients with a history of violent behavior or gang
Institute a sign-in procedure with passes for visitors, especially
in a newborn nursery or pediatric department. Enforce visitor
hours and procedures.
Supervise the movement of psychiatric clients and patients throughout
the facility. Control access to facilities other than waiting
rooms, particularly drug storage or pharmacy areas.
from working alone in emergency areas or walk-in clinics, particularly
at night or when assistance is unavailable. Employees should
never enter seclusion rooms alone.
Ascertain the behavioral history of new and transferred patients
to learn about any past violent or assaultive behaviors. Establish
a system such as chart tags, log books, or verbal census reports
to identify patients and clients with assaultive behavior problems,
keeping in mind patient confidentiality and worker safety issues.
Update as needed.
Transfer assaultive clients to "acute care units,"
"criminal units," or other more restrictive settings.
Make sure that nurses and/or physicians are not alone when performing
intimate physical examinations of patients.