Background:Nursing care facilities are more than seven times as likely to have a worker injured by workplace violence requiring days away from work compared to the overall rate in the private sector (BLS, 2018b). Several states have implemented regulations requiring workplace violence prevention programs in healthcare facilities, including nursing homes. Methods:The manager responsible for workplace violence prevention programs at twenty long-term care (LTC) facilities in New Jersey (n=9) and Virginia (n=11) voluntarily participated in a face-to-face interview utilizing a validated survey regarding workplace violence programs in their facilities. This project compared the comprehensiveness of nursing home workplace violence prevention programs in New Jersey (NJ) where the "Workplace Violence Prevention in Healthcare Facilities Act" was enacted with the comprehensiveness of programs in Virginia (VA) where no workplace violence regulations exist. Results:Descriptive statistics show that there was variation in workplace violence prevention program components, such as training, reporting, and risk assessments, where some facilities had relatively comprehensive programs and others had weak programs. Virginia, the control state without any workplace violence regulations generally had equal implementation compared to the New Jersey, the regulated state. Overall nursing home characteristics and its relationship to security program implementation was mixed. LTC facilities with above average Centers for Medicare and Medicaid Services (CMS) ratings and non-profit status reported higher utilization of environmental controls. The data shows that facilities in Virginia (non-regulated state), non-profit facilities, corporate owned, and facilities with high CMS ratings tended to have a high level of training. It was also found that corporate owned facilities had more extensive implementation of security programs. Conclusion:This survey demonstrated that nursing home administrators are aware of workplace violence in their facilities and have instituted programs and policies to attempt to address this issue. However, these programs and policies are diffuse and "ad-hoc" in nature, likely making them less effective. A lack of regulatory enforcement and the lack of awareness of regulations contributes to the ineffectiveness of the regulation and implementation of security program elements. Other parameters such as overall nursing home quality (e.g. CMS rating) and corporate versus independent ownership also seemed to impact the comprehensiveness of security programs, but this relationship is multifactorial and less clearly articulated by this study design.
Persons most likely to commit violence include a healthcare facility's own employees as well as visitors and patients. Based on the experiences of a number of hospital security directors, a realistic approach to violence prevention can be taken that will anticipate such violence and prevent major incidents.
How does a security director demon- strate value and influence in an or- ganization? According to the authors, a security director's title or position in an organization's hierar- chy does not guarantee that he or she will demonstrate organizational value or influence. This can only happen as a result ofwhat the director does, how well it is done or in some cases what is not done that should have been done. In this article, they de- scribe some real life achievements ex- perienced at their organization to demonstrate security's value and influence.
More organizations are mov- ing to patient treatment out- side of the traditional hospital and into practices and other off-site locations. As this tran- sition occurs, it is important to establish health and safety programs for the patients and staff at these locations. This is true even if the practices are not part of a hospital accredi- tation program as there are other regulatory agencies which affect the operations of these off-site locations.
A critical issue facing all health- care employees is the number of patients dependent on themfor safety and security at all times. Not only must employees learn to survive an active shooter or other violent situation, they also have a moral and ethical obliga- tion to protect others, the author maintains. In this article, she de- scribes the kind of effective train- ing and preparedness that can make a difference.
New tools such as cloud-based access control have created new opportunities for chang- ing the way that electronic se- curity systems can interact, according to the author He describes how such software has made it easier and less costly for health systems to cope with change and how IT and physical security can work together in this critical area.
This article presents a compre- hensive review of ways to min- imize threats and occurrences of violence in healthcare. The authors provide a number of resources available for devel- oping programs for mitigating and responding to such violence.
Violence against healthcare staff members far exceeds the national rate of occupational violence and is never part of the job, the author says. In this article, he lists measures to consider for effectively pre- venting and mitigating as- saultive and threatening purposeful behavior by pa- tients, family members, and outsiders.
How does a security director demon- strate value and influence in an or- ganization? According to the authors, a security director's title or position in an organization's hierar- chy does not guarantee that he or she will demonstrate organizational value or influence. This can only happen as a result ofwhat the director does, how well it is done or in some cases what is not done that should have been done. In this article, they de- scribe some real life achievements ex- perienced at their organization to demonstrate security's value and influence.
With providing support for pa- tients with mental health chal- lenges growing as a priority almost daily, according to the author, the need to create a quality mental health patient 24/7 watch program has be- come essentialfor security planner In this article he dis- cusses the building of a watch team, best practices for watch team operation, and the key ingredients that make for a quality support program.
In dealing with any type of emergency event, large or small, healthcare leaders should start with ensuring proper safety and security measures are in place, the author says, adding that a starting point should be an evaluation of the security pro- gram, the security profession- als at your site and their training. In this article, he de- lineates how security should be involved in all aspects of emergency situations.
This new study by HSS offirearm discharge data in hospitals over the last 10 years reveals that these events have occurred in all states but one, in both urban and rural locations, and in a variety of hos- pitals by size. The number of in- stances has continued to increase, the study finds, confirming the es- calation of violence in healthcare settings. These findings suggest that hospitals of all sizes and lo- cales are at risk of a firearm dis- charge, the authors report, and should consider this exposure in their assessment of security risk and mitigation planning.
In this article, the author, one of the pioneers in the develop- ment of threat assessment systems, presents the core con- cepts that healthcare security directors will need to under- stand in helping employees who require assistance in dealing with stalking, domestic violence, or other potentially violent situations.
Robot security officers cur- rently are now available to perform functions which are not cost-effective for humans, according to the author who heads a company which manu- factures them. In this article he describes the capabilities of robot officers and their uses in healthcare security and safety.
The increased number of be- havioral health patients in our hospitals whose needs are fre- quently met by caregivers without sufficient behavioral healthcare experience or training, has made it difficult to manage the disruptive be- haviors of seriously ill behav- ioral health patients. How do we meet the need, stay within a reasonable budget, and in- crease safety and confidence in our caregivers? The answer according to the author, is the Behavioral Response team (BRT). In this article, he de- scribes how to develop the team, the roles of its members, and how it responds to a crisis situation.
Following attendance by hos- pital security officers at a law enforcement active shooter training course, the author conducted nine quarterly drills at a vacant hospital involving security, outside law enforce- ment, medical staff and other employees. Drills were also conducted at the hospital ' off- campus locations. In this arti- cle he details the lessons learned from the drills.
The authors describe the issue of workplace violence in hospitals, a New Jersey state law and regula- tions regarding workplace vio- lence in healthcare, and some innovative strategies that are being utilized to help reduce the occurrence and risk of violence. The authors also discuss compli- ance with the New Jersey regula- tions.
The new CMS Final Rule on Emer- gency Preparedness will be a major change for hospitals and many other types of healthcare providers, the authors claim. One of the most im- portant changes for hospitals will be the requirement to do the Security Risk Assessments and matching Emergency Plans for each separate facility, every year, instead of only doing a consolidated risk assess- ment on all facilities in one report. Failure to comply could have a major and disastrous economic im- pact on a hospital or other health care facility. In this article they pro- vide information and access to re- sources for complying.
In this comprehensive guide to workplace violence in health- care, the author describes in detail an effective multi-tiered training program that ad- dresses the entire spectrum of workplace violence related be- haviors. Through such prepa- ration, assessment, and education, he says, the health- care professional can reduce the incidence and/or severity of workplace violence issues.
