Violation Detail
Standard Cited: 5A0001 OSH Act General Duty Paragraph
Inspection Nr: 311473250
Citation: 01001
Citation Type: Serious
Abatement Date: 08/17/2010 X
Initial Penalty: $6,300.00
Current Penalty: $6,300.00
Issuance Date: 07/01/2010
Nr Instances: 127
Nr Exposed: 2600
Related Event Code (REC):
Gravity: 10
Report ID: 0111500
Contest Date:
Final Order:
Emphasis:
Text For Citation: 01 Item/Group: 001 Hazard: FALLING
Section 5(a)(1) of the Occupational Safety and Health Act of 1970: The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that employees were exposed to fatal or serious physical injuries from violent patients. Danbury Hospital: Employees were exposed to the hazard of being assaulted by violent patients causing fatal or serious physical injuries while working in the psychiatric ward, emergency department's behavioral care unit, and the general medical floors. Within the past five years there have been approximately 25 cases which have resulted in 212 restricted duty days and 399 days away from work as well as 119 non-recordable cases as a result of gunshot wounds; serious fractures; contusions; bites; head injuries; being punched in the face; being hit and kicked by violent patients in the psychiatric ward, emergency department and the general medical floors. Some of the contraband patients have been successful in bringing into the hospital include: a gun; box cutters; knives; razor blades; lighters; and drug paraphernalia. On or about March 23, 2010 a nurse was kicked by a patient while security was trying to hold down the patient in the psychiatric ward. On or about March 2, 2010 a elderly man shot a nurse three times in 8 tower west. On or about October 11, 2009, a patient struck a nurse in the jaw causing her to fall down and break her hip in the psychiatric ward. On or about May 18, 2009, a security guard was beaten up in the behavioral care unit. On or about December 31, 2008, a patient lunged at a nurse striking her in the arm in the psychiatric ward. Among other methods, feasible and acceptable means to abate the hazard of workplace violence in Danbury Hospital include: 1) Create a stand alone written Workplace Violence Prevention Program for the entire hospital which includes the following elements: A Workplace Violence Policy Statement including responsibilities of all staff Hazard/Threat Assessment including records review, inspection of the worksite, and employee survey Implementation of Workplace Controls and Prevention Strategies Training and Education of all Staff Incident Reporting and Investigation Periodic review of the program; 2) Ensure that the program addresses the specific actions employees are to take for an incidence of workplace violence in the hospital, as well as the proper procedures to report those incidences; 3) Ensure that security staff members are readily and immediately available to render assistance in the event of an incidence of workplace violence and that security has had specialized training to deal with aggressive behavior. 4) Conduct more extensive training so that all employees are aware of what the hospital's workplace violence policy is, and where that information can be found. In addition, train all employees to state clearly to patients, clients, and employees that violence is not permitted or tolerated. Further train all employees on recognizing when a patient is exhibiting aggressive behavior and techniques for de-escalating that behavior. 5) Ensure that all patients who receive a psychiatric consultation are screened for potential history of violence before being admitted to the hospital. In addition, consider using hand held metal detecting wands to detect weapons that may be concealed by the patient. 6) Use a system to flag the patient's chart anytime there is a history or act of violence and train staff to understand the flagging system. Put procedures in place that would allow communication of any incident of workplace violence to the staff that might come in contact with that patient, so that employees who might not have access to a patient's chart would be aware of a previous act of aggression or violence. 7) In the psychiatric ward, the optimal abatement would be to make the psychiatric ward a one floor unit so that employees are not alone with patients on the floor. In lieu of creating a one floor unit, administrativecontrols should be put in place to prevent employees from being alone with patients. In particular, employees should not be transporting potentially violent patients alone in stairwells or in elevators. Security should be present and available immediately in the event of an incidence of violence.
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