Violence and Aggression by Patients Consumers or … · Web viewThis policy and SOP addresses all forms of violence, aggression, discrimination, bullying and harassment carried out

DGD15-019

PolicyViolence and Aggression by Patients, Consumers or Visitors:Prevention and Management

Policy StatementAll staff, patients, consumers and visitors have the right to healthcare settings that are therapeutic, safe and free from violence and aggression. It is well documented that violence and aggression towards staff by patients, consumers and visitors is a known risk in health services.

ACT Health does not tolerate purposeful violence. ACT Health has a responsibility under the Work Health & Safety Act 2011 to take all reasonable steps to ensure the workplace is safe and without risk.

ACT Health addresses violence and aggression by patients, consumers or visitors in the workplace using a risk management approach. The following standard operating procedure (SOP) supports this policy:

Violence and Aggression by Patients, Consumers or Visitors: Environmental and Worlplace Risk Management and manageing an Incident and Ongoing Isssues.

PurposeThe purpose of this policy and associated SOP is to provide staff with clear information on how to prevent and manage violence and aggression in ACT Health.

ScopeThis policy and SOP addresses all forms of violence, aggression, discrimination, bullying and harassment carried out against staff by patients, consumers or visitors.

Management of staff-on-staff violence, aggression, discrimination, harassment and bullying is not addressed in these documents. Refer to: Public Sector Management Act 1994 & PSM Standards 2006; Respect at Work Policy and SOP.

Further information and implementation tools, e.g. templates, checklists are provided on the ACT Health Work Health and Safety Management System (WHSMS) Intranet web page.

When applying the risk management principles to the prevention and management of violence and aggression, Divisions, Branches and Units may need to develop local SOPs in their own areas using the approach outlined in this document and associated SOPs.

Document Number Version title>

Issue Date Review Date Area Responsible

DGD15-019 May 2015 May 2018 Workplace Safety

Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register

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DGD11-093Roles and ResponsibilitiesIt is the responsibility of all staff to be familiar with the ACT Health Preventing and Managing Violence and Aggression Policy and associated SOP.

Director-General and Executive DirectorsIt is the responsibility of the Director-General and Executive Directors to:

Implement and maintain workplace health and safety policies, procedures and practices that ensure the physical and psychological safety of ACT Health staff, patients, consumers or visitors

Promote the physical and psychological well being of ACT Health staff Lead by example and reinforce that violence and aggression is unacceptable in the

workplace Provide a work environment to prevent or reduce incidents of workplace violence

and aggression wherever possible Determine cases of withholding treatment in line with the SOP, when required and

when other measures have been unsuccessful Consider endorsement of proposed workplace protection order applications put

forward by staff Provide resources for mediation services, and Ensure natural justice is applied to all parties.

Managers It is the responsibility of Managers to lead by example and reinforce that violence and aggression is unacceptable in the workplace, by enabling:

Staff compliance with the policy All incidents to be reported in Staff Accident Incident Report (SAIR)/Riskman All staff to access, interpret and apply the policy and associated SOP All staff to undertake training in risk management of violence and aggression in the

workplace, appropriate to their work area Workplace Safety inclusion on the agenda of staff meetings Staff awareness of their options and supported recovery from incidents of violence

and aggression through Staff Assistance Program (EAP) and a return to work program as appropriate

Access to information on the Violence and Aggression by Patients, Consumers or Visitors: Prevention and Management Policy and SOPs available for patients, consumers or visitors

A prompt response to and investigation of reports of any forms of violence and aggression and risk management processes are in place to avoid repetition by the person responsible

Local SOPs to be developed, specific to local workplace culture, situations and needs when required

Violence and aggression management in accordance with the SOP and incidents to be appropriately escalated to Executive Directors and the Director-General as part of reporting, and

Submission of applications for workplace protection orders to the Director-General on behalf of staff.

Document Number Version

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DGD15-0 V3 May 2015 May 2017 WorkPlace Safety

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DGD11-093StaffIt is the responsibility of staff to:

Be aware, understand and comply with the ACT Health policy and SOPs Undertake the appropriate violence and aggression training for the workplace Wear a personal duress alarm in accordance with local SOPs Ensure personal behaviour does not contribute to violence or aggression Know their options when confronted with violence and aggression Report promptly ALL incidents of violence and aggression using the ACT Health

incident reporting system, and Report acts of violence to police when appropriate in consultation with managers.

Workplace SafetyIt is the responsibility of Workplace Safety to:

Provide guidance and advice in the prevention of violence including identification of factors which may contribute to aggression or violence, risk assessment and control strategies, and e-Learning Personal Safety and Conflict Awareness Training

Record, monitor and review reported incidents and escalate reports to the relevant managers, and

Provide monthly reports of violence and aggression incidents to the Director-General, Deputy Director-General, and Executive Directors.

Provide quarterly reports to the security committee.

People Strategy and Services (PSS)It is the responsibility of PSS to:

Oversight the rehabilitation needs of staff.

Business and InfrastructureClient Services, Security and Emergency It is the responsibility of Client Services, Security and Emergency to:

Conduct reviews and inspections of ACT Health sites with respect to security requirements and provide advice in written reports

Maintain duress systems in good working order in consultation with Property Management & Maintenance, Workplace Safety and work areas

Provide appropriately trained guarding services suitably orientated to the health environment and its client base

Provide an emergency response at the Canberra Hospital Respond quickly to Police requests for Closed Circuit Television (CCTV) footage, and Maintain access control systems and effective staff access Capture and report on all code black incidents.

Property Management & MaintenanceIt is the responsibility of Property, Management and Maintenance to provide timely maintenance on secured items which could be used as weapons or missiles.

EvaluationOutcome Measures

Increase in number of staff who have completed Personal Safety and Conflict Awareness training


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DGD11-093 Incidents are appropriately managed in accordance with the policy and SOP Reduction in the level of risk of each incident.

MethodWorkplace Safety will audit and evaluate the effectiveness of the policy through:

Reports of violence and aggression in ACT Health to Workplace Safety through SAIR Completion of the SAIR fields ‘Investigations/Findings’ and ‘Controls Implemented’ Workplace Safety investigations of high and extreme risk rated incidents of violence

and aggression

Ward Services and Security can evaluate the effectiveness of the policy through: Ward Services advice of hours spent with aggressive patients, consumers per year Reduction in the number of Code Blacks per year reported through Communications

Room as advised by Security Security advice of incidents per year recorded in Riskman code Black Register Consumers secluded per year (Seclusion Review Committee, Emergency Department

and Psychiatric Services Unit) and the total hours, and Staff injuries related to patient, consumer and visitor violence and aggression

reported per year via Riskman.

Workplace Safety will report on workplace violence and aggression to: Health and Safety Committees Divisional Executive meetings with Workplace Safety Director as required.

Related Legislation and PoliciesLegislationCommunity and Health Services Complaints (Amendment) Act 1997Crimes (Amendment) Act (No. 2) 1991Domestic Violence and Protection Orders Act 2008Discrimination Act 1991Health Records (Privacy and Access) Act 1997Human Rights Act 2004Human Rights Commission Act 2005Mental Health Act 2015Occupational Health and Safety Act 1989Public Sector Management Act 1994 & PSM Standards 2006Health Records (Privacy and Access) Act 1997Safety, Rehabilitation and Compensation Act 1988Victims of Crime Amendment Act 2007Work Health & Safety Act 2011

PoliciesRespect at Work Policy and SopConsumer Feedback Management Policy and ProceduresPreventing and Managing Violence and Aggression policy and standard operating procedureWork Health & Safety Policy (March 2015)


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DGD11-093ReferencesKlee A., Benveniste, Hibbert P. 2004 - Violence and aggression in Health Care - Insights from the Australian Incident Monitoring System

National Audit Office, 2000 - A Safer Place to Work: Protecting NHS Hospital and Ambulance Staff from Violence and Aggression

NHS zero tolerance zone 2000 - We don’t have to take this - Resource Pack

NHS zero tolerance zone 2000 - Withholding treatment from violent and abusive consumer/patient/client in NHS Trusts

NSW Health, 2003 Zero Tolerance - Response to violence in the NSW Health workplace - Policy and Framework Guidelines

NSW Heath, Department Policy and Guidelines (No: HRB 92-26)

Mayhew C., Chappell D. 2001 – Prevention of Occupational Violence in the Health Workplace. School of Industrial Relations and Organisational Behaviour and Industrial Relations Research Centre, the University of New South Wales

Victorian Government Department of Human Services, 2004. Industry occupational health and safety interim standards for preventing and managing occupational violence and aggression in Victoria’s mental health services. http://www.health.vic.gov.au/mentalhealth/atoz.htm

Workers Compensation Board of British Columbia, 2000. Preventing violence in health care: five steps to an effective program.

WorkSafe Victoria June 2008 Prevention and management of aggression in health services – A handbook for workplaces Edition 1

WorkSafe Victoria April 2010 Prevention and management of aggression in health services – A toolkit for workplaces Edition 1


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http://www.health.vic.gov.au/mentalhealth/atoz.htm

DGD15-019

DefinitionsBullyingThe repeated unwelcome behavior of a person which has the potential to cause harm to a person/s wellbeing (e.g. verbal abuse, putting someone down, spreading rumors or innuendo, exclusion, interfering with personal property or work equipment). Bullying can:

Be characterised by continued aggressive behaviour that intimidates, humiliates or undermines

Involve the deliberate misuse of power and can come from people at level, above or below the recipient in the hierarchy, and

Occur outside of work location or hours and still affect a staff member’s work performance or well-being.

Code Black/Emergency Procedure is an emergency response used within the Canberra Hospital (TCH) campus when there is assault, violence or high risk of violence displayed by a consumer or visitor who is deemed to be unmanageable and dangerous.

DiscriminationUnfair treatment of an individual or group of people because they belong to, or are associated with a particular individual or group, or because they are have a particular characteristic or attribute.

Employee Assistance Program (EAP)The EAP is an independent and confidential counselling service provided for staff free of charge. Details of the EAP are available on the ACT Health Intranet site or from Injury Prevention and Management.

HarassmentAny form of behaviour that is unwelcome, offensive, humiliating, or threatening. This can include creating an atmosphere that is offensive, humiliating or threatening. Harassment may have occurred even when there was no intention to cause offence.

Violence and Aggression In this document occupational violence and aggression refers to any incident where staff member(s) are abused, threatened or assaulted in the course of their work. Observation of violence and aggression can also adversely affect staff.

Weapon A weapon is a tool used to injure, incapacitate, or kill. Any object used to cause damage, even psychologically, is referred to as a weapon.




Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register

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DGD15-019

Workplace Protection Order (WPO) The ACT Magistrates Court may, on application, make a workplace order if satisfied that a consumer: Has engaged in personal violence in relation to the workplace, and May engage in personal violence in relation to the workplace during the time the order is

proposed to operate if the order is not made.

A WPO can state the conditions on which the consumer may enter or approach the workplace or contact the employee. It is also able to prohibit the consumer from entering the workplace; being within a particular distance of the workplace; contacting, harassing, threatening or intimidating an employee at the workplace or causing someone else to do so and damaging property in the workplace.

Before making a WPO, serious consideration must be given to the outcome that is hoped to be achieved. While a WPO is effective in preventing violence in some cases, it may not be appropriate in all circumstances. The success of the WPO is dependent on the consumer subject to the order having the capacity and inclination to comply with it.

Given that the issuing of a WPO to an individual(s) is legally enforceable and breaching one may lead to a criminal offence, it may not be appropriate to seek an order where the consumer lacks capacity to comply with it. Similarly, where it is not intended to restrain a consumer from attending the workplace a WPO may have very little practical effect.

AttachmentsAttachment 1 FLOW CHART Responses to Violence and Aggression by Patients, Consumers or Visitors

Associated Standard Operating Procedure (SOP)Violence and Aggression by Patients, Consumers or Visitors: Environmental and Workplace Risk Management and Managing an Incident and Ongoing Isssues.

Disclaimer: This document has been developed by ACT Health, specifically for the use of ACT Health. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and ACT Health assumes no responsibility whatsoever.

Attachment 1




DGD11-093FLOW CHART

Responses to Violence and Aggression by Patients, Consumers or Visitors

POLICY

STANDARD OPERATING PROCEDURES Pathway Order


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DGD15-0 V3 May 2015 May 2017 Workplace Safety

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Violence and Aggression by Patients, Consumers or Visitors: Prevention and Management Policy

Roles and responsibilities Legislation Definition SOP Flow Charts

ENVIRONMENTAL AND WORKPLACE RISK MANAGEMENT Patients, consumers or visitors

Risk management approach Hazard identification Risk assessment Implementation of controls Evaluation and review Consultation Documentation

MANAGING AN INCIDENTPatients, consumers or visitors

Immediate response is required for Early intervention Immediate response Post incident response

Attachments1. Common signs of impending violent and aggressive behaviour2. Flow Chart - Reporting workplace violence and aggression perpetrated

by patients, consumers or visitors.

MANAGING ONGOING ISSUES Patients or consumers (only)

Verbal Warnings Written Warnings

Letter Templates Conditional Treatment Agreement

Letter Conditional Treatment Agreement Templates

Withholding Treatment Workplace Protection Order

Documents

Violence and Aggression by Patients Consumers or … · Web viewThis policy and SOP addresses all forms of violence, aggression, discrimination, bullying and harassment carried out