Training and education ensure all staff are aware of potential security hazards and how to protect themselves and their coworkers through established policies and procedures.
Every employee should understand the concept of "universal precautions for violence"— that is, that violence should be expected but can be avoided or mitigated through preparation. Frequent training also can reduce the likelihood of being assaulted.
Employees who may face safety and security hazards should receive formal instruction on the specific hazards associated with the unit or job and facility. This includes information on the types of injuries or problems identified in the facility and the methods to control the specific hazards. It also includes instructions to limit physical interventions in workplace altercations whenever possible, unless enough staff or emergency response teams and security personnel are available. In addition, all employees should be trained to behave compassionately toward coworkers when an incident occurs.
The training program should involve all employees, including supervisors and managers.
New and reassigned employees should receive an initial orientation before being assigned their job duties. Visiting staff, such as physicians, should receive the same training as permanent staff. Qualified trainers should instruct at the comprehension level appropriate for the staff. Effective training programs should involve role playing, simulations and drills.
Employees should receive required training annually. In large institutions, refresher programs may be needed more frequently, perhaps monthly or quarterly, to effectively reach and inform all employees.
Training topics may include management of assaultive behavior, professional assault-response training, police assault-avoidance programs or personal safety training such as how to prevent and avoid assaults. A combination of training programs may be used, depending on the severity of the risk.
The training should also cover topics such as:
Supervisors and managers need to learn to recognize high-risk situations, so they can ensure that employees are not placed in assignments that compromise their safety. They also need training to ensure that they encourage employees to report incidents.
Supervisors and managers should learn how to reduce security hazards and ensure that employees receive appropriate training. Following training, supervisors and managers should be able to recognize a potentially hazardous situation and to make any necessary changes in the physical plant, patient care treatment program and staffing policy and procedures to reduce or eliminate the hazards.
Security personnel need specific training from the hospital or clinic, including the psychological components of handling aggressive and abusive clients, types of disorders and ways to handle aggression and defuse hostile situations.
The training program should also include an evaluation. At least annually, the team or coordinator responsible for the program should review its content, methods and the frequency of training. Program evaluation may involve supervisor and employee interviews, testing and observing and reviewing reports of behavior of individuals in threatening situations.
UMC Brackenridge in Austin, Texas, realized that getting everyone to practice high reliability safety behaviors would not come easy. After all, it would require associates to be prepared to speak up and say to a colleague, or even a superior, “Excuse me, I feel at-risk for violence.”
Even though 100 percent of associates had received high reliability safety training, the hospital realized that it would need to do more. To help drive this practice throughout the organization, the hospital identi¬fied a select group of associates who showed a passion and interest in safety. These employees became “Safety Coaches” and were given additional training to equip them with the skills to create alignment and build consensus.
The Safety Coaches meet regularly to discuss situations, share ideas, and learn from each other. UMC Brackenridge credits its Safety Coach initiative with fostering an environment where every employee is empowered to intervene in a non-threatening, non-judgmental manner, and to question any other employee about a behavior, process, or procedure.
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