Text For Citation: 01 Item/Group: 001 Hazard:

OSH ACT of 1970 Section (5)(a)(1): The employer did not furnish employment and a place of employment which was free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that employees are exposed to the hazard of workplace violence: a) On or about December 26, 2015, employees were exposed to verbal and serious physical assaults while providing nursing care services to clients. b) On or about March 8, 2016, employees were exposed to verbal intimidation and threats of serious physical assaults while providing nursing care services to clients. Abatement certification and documentation required within 10 days after abatement date. The certification shall include a statement that abatement is complete, the date and method of abatement, and state that employees and their representatives were informed of this abatement. Abatement documentation shall include documents demonstrating that abatement is complete, such as evidence of the purchase or repair of equipment, photographic or video evidence of abatement or other written records. Among other methods, feasible and acceptable means to abate the hazard of workplace violence include: 1. Develop a written, comprehensive workplace violence prevention program which should include: a. A policy statement regarding potential violence in the workplace and assignment of oversight and prevention responsibilities. The policy must clearly define workplace violence hazards employees may encounter including, but not limited to, sexual and physical violence. Ensure the policy is conveyed to employees, clients, and household members. b. Workplace violence hazard assessment and security procedures that are used for each new client. Such procedures should identify the risks employees may face and how the employer will address the specific hazards identified. c. Development of workplace violence controls, including implementation of engineering and administrative controls and methods used to prevent potential workplace violence incidents. i. Policies and procedures covering visits by home health-care providers to address the conduct of home visits, the presence of others in the home during visits, and the worker's right to refuse to provide services in a clearly hazardous situation without fear of retaliation. ii. Develop and implement a written policy of non-tolerance for workplace violence. Managers and supervisors must share the policy with employees, clients, family members, and visitors and must verbally advise them that violence is not permitted or tolerated. iii. Determine the behavioral history/ background checks of new and existing clients to learn about any past violent or assaultive behaviors. Establish a system such as chart tags or log books to identify clients with assaultive behavior problems. Be cognitive of patient confidentiality and worker safety issues. Update clients? behavioral histories as needed. Review workplace violence incidents from the previous shift during change-in shift meetings. iv. Maintain records of family members? violent behavior experienced by employees and establish a system, such as chart tags or log books to ensure employees are provided this information. v. Provide personal protective equipment (PPE) such as panic buttons and Kevlar sleeves to employees exposed to clients who have a tendency to bite. vi. Encourage employees to promptly report incidents and train them on ways to reduce or eliminate risk. d. A recordkeeping system designed to report any violent incidents. The reports must be in writing and maintained for review after each incident and at least annually to analyze incident trends. i. Require and ensure that employees report all assaults or threats to a supervisor or manager, regardless of severity. Investigate all violent incidents and threats. Implement appropriate recommendations resulting from incident investigations. e. Development of a workplace violence training program for all employees so they are aware of the potential hazards and means to protect themselves and coworkers through established policies and procedures. The training shall include the employer's workplace violence prevention program and what procedures and practices to follow in the workplace, to include a client's home or alternate location. i. Include in the program elements how to identify and defuse a situation prior to it becoming an escalated incident. ii. Ensure training is provided to employees prior to beginning work, and should also occur when significant changes are made to policies and procedures. Annual refresher training should be provided to all staff. f. Annual review of the workplace violence prevention program and updated as necessary. Such review and updates shall set forth any mitigating steps taken in response to any workplace violence incidents. g. Development of procedures and responsibilities to be taken in the event of a violent incident in the workplace. Advise employees of company procedures for requesting police assistance or filing charges when assaulted and help them do so, if necessary. Provide prompt medical and psychological evaluations and treatment after the incident. h. Ensure employees utilize a buddy system while providing service to clients in a household with client or family member with a history of violence. i. Develop and implement a formal weapons policy that includes procedures for employees to follow, as well as employee training on such procedures. j. Establish a relationship with local police authorities.