Transcript Lecture 12 man

Effective Leadership and
Management in Nursing
EIGHTH EDITION
CHAPTER
23
Preventing
Workplace
Violence
Learning Outcomes
1. Discuss what health care organizations
can do to prevent violence.
2. Identify threats and threatening
behaviors.
3. Describe how to recognize escalating
violence.
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Learning Outcomes
4. Discuss how to respond to a violent
incident.
5. Describe how to handle the follow-up
to a violent incident.
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Workplace Violence
• Any violent act, including physical
assaults and threats of assault, directed
toward persons at work or on duty
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Examples of Violence
• Violence includes:
– Threatening actions
 Waving fists, throwing objects, or
threatening body language
– Verbal or written threats
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Violence Examples
• Violence includes:
– Physical attacks
 Slapping, hitting, biting, shoving, kicking,
pushing, beating
– Violent assaults
 Rape, homicide, and attacks with
weapons, such as knives, firearms, or
bombs
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Consequences of Violence
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Affects staff morale
Increases staff stress
Causes mistrust of administration
Exacerbates hostile work environment
Increases costs because of
absenteeism, turnover, and additional
health costs for injured workers
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Factors Contributing
to Violence
• Patients with head trauma, seizure
disorders, dementia, alcohol or drug
withdrawal, or who are homeless
• Crime victims and perpetrators
• Family members' stress and fear, long
waits
• Absence of visible, armed security
personnel
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Violence Risk Factors
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Working understaffed
Long waiting times
Overcrowded waiting rooms
Working alone
Inadequate security
Unlimited public access
Poorly lit corridors, rooms, and parking
lots
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Preventing Violence
• Health care organizations:
– Required to provide safe work
environment
– Must develop adequate policies to
address violence in the workplace
– Inadequate policies may result from
lack of awareness
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Zero-Tolerance Policies
• Anyone who becomes violent or who
exhibits threatening behavior must be
removed from the setting and the
authorities contacted
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Reporting and Education
• Educate staff to recognize warning
signs of violence and potential
assailants or agitators
• Educate staff about conflict resolution
skills and de-escalation tactics
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Environmental Controls
• Adequate lighting
• Security devices
• Bullet-resistant barriers (emergency
department)
• Curved mirrors in hallways
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Environmental Controls
• Adequate staffing
• Judicious use of restraints or seclusion
• Alerting staff about patients with
history of violent behavior, dementia,
or intoxication
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Threatening Behaviors
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Clenched fists
Blank stare
Fighting stance
Arms raised in fighting position
Standing too close or advancing
Holding weapon of any kind
Overt intent
Movement toward exit
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Escalating Violence
• Verbal threats often precede a
physically violent event
• Abuser might be encouraged by a
crowd or afraid to lose face
• Watch body language and keep
distance
• Use clear, direct words or silence
• Keep tone calm
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Responding to a Violent Incident
• Notify security immediately
• Never try to disarm someone
• If person is not armed, enlist staff to
help in restraining violent person
• Put a barrier between violent person
and yourself
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Post-Incident Follow-Up
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Be certain everyone is safe
Arrange treatment for injured
Complete injury and incident reports
Follow up with Human Resources
Contact security
Contact injured employee at home to
express concern and answer questions
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan