UNITED STATES
DEPARTMENT OF LABOR

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

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 was free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that employees were exposed to the hazard of workplace violence. On or about February 7, 2014 through April 12, 2014, Brookdale University Hospital and Medical Center employees were exposed to violent assaults and physical threats by patients and visitors ¿ including hitting, kicking, and punching, which resulted in head, eye, face, hand, groin and other bodily injuries ¿ while performing routine duties throughout the hospital facility. One instance, on or about February 7, 2014, involved an evening nurse in the 5th floor, CHC Department, who was attacked while attending to a patient and was repeatedly kicked in the head, resulting in severe brain damage. Among other methods, feasible and acceptable means to abate the workplace violence at Brookdale University Hospital and Medical Center include: 1) Engineering Controls: - Install and regularly maintain alarm systems and other security devices, panic buttons, hand held alarms or noise devices at workstations or worn. - Use a closed-circuit video recording for high-risk areas on a 24-hour basis. - Enclose nurse's stations and/or have a security doors to prohibit access to area, install deep service counters or shatterproof glass in reception triage and admitting areas or client rooms. - Provide metal detectors; hand held or installed. - Secure furniture and other items that could be used as weapons. 2) Administrative Controls: - Develop and implement an effective and comprehensive violence prevention program that includes management commitment/employee involvement, worksite analysis, hazard prevention and control, safety and health training, recordkeeping and program evaluation. - Implement, maintain or improve a system and procedures to perform a root cause or similar type of analysis for every incident of work place violence. The hospital should also review and evaluate the data collected to identify patterns and trends. The analysis should be used to identify and implement the types of hazard prevention and control measures needed to reduce the likelihood or eliminate the possibility of an incident of workplace violence from occurring. - Establish a system such as chart tags, log books or verbal census reports to identify patients, clients and visitors with a history of violence. - Ensure that all new and transferred patients are promptly screened for potential violence and past violent or assaultive behavior, and that such screening is considered when assigning patients to particular areas of the hospital. - Evaluate workplace controls and implement new policies and procedures when appropriate to reduce violence in the workplace. - Use properly trained security officers to deal with aggressive behavior. Follow written security procedures. - Develop building access control procedures to include a sign in procedure with passes for visitors. Enforce visitor hours and procedures. - Establish a list of restricted visitors for patients with a history of violence or gang activity. Make copies available at security checkpoints, nurse's stations and visitor sign-in area. - Use the "buddy system" especially when personal safety may be threatened. - 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 the employees who might not have access to a patients chart would be aware of a previous act of aggression or violence. - Ensure that security staff members, and/or a response team other than employees on the floor are readily and immediately available to render assistance in the event of an incident of workplace violence and that all are provided with specialized training to deal with aggressive behavior. - Ensure that the psychiatric floors/areas have sufficient security staffing. - The employer shall create a safety committee to assist in the development, implementation, monitoring, and evaluation of the Workplace Violence Prevention Program. The committee should be made up of representatives from management, security, and labor, as well as representatives from all departments and shifts. The committee should be involved in all aspects of worksite analysis, hazard prevention and control, training, recordkeeping and program evaluation. 3) Employee Training: - Conduct training for all employees so they are aware of what the hospital's Violence Prevention Plan in the Workplace plan is and what procedures to follow to address the hazard. Conduct comprehensive mandatory training specific to the prevention of workplace violence, early recognition of aggressive or violent behavior and techniques for conflict resolution. - Conduct training for all employees so they are aware of the mandatory requirement to report all incidents of workplace violence which include: verbal threats, nonverbal threats, threats of bodily harm or intimidation, physical assault and/or menacing. - Develop Post-Incident Procedures and Services to provide comprehensive treatment for employees who may be traumatized by witnessing or being involved in a workplace violence incident.