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Joint Commission: screening for violence

Accreditation Insider, October 3, 2017

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In the October edition of Perspectives, The Joint Commission reiterated the need to screen patients for potential risks to themselves or others. This is part of a long-standing and ongoing effort to change the sky-high rates of workplace violence in healthcare.

More than 70% of the 23,000 significant injuries resulting from workplace assault in 2013 happened in healthcare and social service settings, according to the Bureau of Labor Statistics. The settings with the highest rates of workplace violence are emergency departments, behavioral healthcare settings, extended care facilities, and inpatient psychiatric units.

After reviewing 145 sentinel events between 2013 and 2015, The Joint Commission wrote that a common cause of violence was an inadequate behavioral health assessment of patients to identify aggressive tendencies. Sometimes, these assessments weren’t done at all, and the results ranged from assault to rape and even death.

“In order to accurately assess the needs of an individual for care planning, it is important to collect data about the individual’s past emotional and behavioral functioning, to assess his/her current needs and goals, and to analyze the data collected in order to develop a plan of care, treatment, or services that effectively addresses the risk of harm to self or others,” The Joint Commission writes. “These steps are also important to determine if there is a need to collect additional information.”

This includes checking to see if the patient has a history of violent behavior. If so, is there anything in their record that could determine if they’ll repeat their actions?

“If there is a history of aggression, or if the individual is admitted in an agitated state, staff should be alerted and the preliminary plan of care, treatment, or services should address the interventions required to maintain the safety of the individual and others,” “…the Perspectives article continued. “Interventions in the preliminary plan of care would likely include close supervision and monitoring of the individual, individualized de-escalation strategies, and adjustments to the environment of care as needed.”

Here are some other free resources and training on workplace violence prevention:

1.    Workplace Violence Prevention Resources for Health Care Portal (www.jointcommission.org/workplace_violence.aspx)   
2.    OSHA’s Guidelines for Preventing Workplace Violence in Healthcare and Social Services (www.osha.gov/Publications/osha3148.pdf)  
3.    OSHA’s Preventing Workplace Violence: A Road Map for Healthcare Facilities (www.osha.gov/Publications/OSHA3827.pdf)
4.    The Center for Health Design’s Safety Risk Assessment Toolkit
       (www.goo.gl/eH9IbG)
5.    The CDC’s Workplace Violence Prevention for Nurses course (www.cdc.gov/niosh/topics/violence/training_nurses.html)
6.    The Emergency Nurses Association’s Workplace Violence Toolkit
(www.goo.gl/0GXblW)
7.    ASIS International’s Managing Disruptive Behavior and Workplace Violence in Healthcare
(www.goo.gl/MDGsrf)

 



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