Protecting Health Care Workers from Workplace Violence at California Mental Health & Jail Facilities Chris Kirkham, MPH, CIH, CSP Senior Safety Engineer for Health Cal OSHA Enforcement 510-286-1066 [email protected]

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Top 3 Causes of Occupational Fatalities in California, 2010

Cause

Transportation Falls Homicides All causes

Number dead

98 66 44 326

http://www.dir.ca.gov/dosh/cfoi/CFOI_2010/cfoi2010.htm

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Relationship between a violence perpetrator and the workplace Presentation covers this category None. Enters only to pursue criminal activity Service recipient Current or former employee Personal 3

CalOSHA has jurisdiction over workplace violence hazards T8 CCR 3203 Injury and Illness Prevention Program – program administrator – enforcement – communication – hazard identification and evaluation – injury investigation – hazard correction – training 4

CalOSHA has jurisdiction over workplace violence hazards T8 CCR 6184 Employee Alarm Systems – audible – tested – maintained – actuators unobstructed and conspicuous – employees trained – sounding procedures established T8 CCR 3220 Emergency Action Plan – writen plan – training 5

Stationary alarms for violent events • • • • • • • Observed problems: Not aware system exists Actuators covered Actuators inconspicuous Different buttons & indicators not understood Broken actuators Broken speakers & inaudible areas Not tested 6

Training • • • should cover: – escalation phases, de-escalation & escape techniques – the full range of scenarios – worksite specific issues and policies universal/3 rd -party curriculums – sometimes constitute only training provided – often cover necessary but not all needed subjects sometimes miss entire job classifications 7

Communication: patient hazards & assault assistance • • • regularly appraise employees of patients’ status many units have only a few stationary panic buttons yelling or whistling for help not an effective system, personal alarm needed 8

Communication: temporary presence of non-regular EEs • Two-way exchange necessary – Warnings and updates – Allows monitoring and adjustment – Screen incoming and account for outgoing items – Provide personal alarms 9

evaluate & control: proximity to employees & access to loose objects Inmate has immediate access to RN & loose objects Inmate distanced, loose objects removed or bolted 10

evaluate & control: proximity to employees & loose objects • • barrier islands preferable during certain interactions ordinary tools can be overlooked weapons 11

Inspect & control hazardous personal belongings • robust search and/or secure storage necessary for street items 12