Relias, LLC is an approved provider of continuing education by the California Department of Public Health, Provider # NAC7001.
The certificate must be retained by the licensee for a period of four (4) years after the course is completed.
This learning activity meets the definition of *** ONLINE *** CEUs. This activity is approved for 1.00 contact hours.
I. Introduction a. What is Workplace Violence? b. Four types of workplace violence c. The prevalence of workplace violence in healthcare II. California Regulations Governing Workplace Violence a. California has the most rigorous regulations protecting healthcare workers from workplace violence — in some cases, California’s new workplace violence regulations reinforce or enhance these existing regulations: b. Statewide Illness Injury Prevention Program (IIPP) (CCR Section 2302) c. The Workplace Violence Safety Act (Code of Civil Procedure Section 527.8) d. HSC 1257.7 and 1257.8, regulating workplace violence in general acute care hospitals, acute psychiatric hospitals, and special hospitals III. The Workplace Violence Prevention in Health Care Rule a. Scope b. Timeline for Implementation c. Workplace Violence Prevention Plan i. General guidelines: Must be available in writing, specific to relevant hazards, available to all employees ii. Must include: 1. Names or job titles of implementers 2. Effective procedures 3. Methods of coordination 4. Methods for obtaining assistance from law enforcement 5. Report and response procedures 6. Compliance mechanisms 7. Communication policies, including: a. Inter-employee communication b. Reporting to superiors c. Eliminating fear of reprisal d. Investigation procedures 8. Procedures to develop training 9. Environmental Risk Assessment procedures a. Environmental risks to consider in home facility b. Procedures for identifying environmental risks in external locations c. Environmental risks during transit and dispatch 10. Risk Assessment Procedures a. At-risk populations b. Mental status/condition c. Treatment/medication status d. History of violence e. Disruptive or threatening behavior 11. Procedures to Correct hazards in a timely manner a. Sufficient numbers of trained staff b. Enhancing visibility and communication c. Configuring safe facility spaces d. Violence-proofing spaces, furniture, and objects e. Preventing transport of weapons into facility f. Maintaining sufficient staffing g. Establishing and maintaining alarm system h. Creating means of alerting employees to threats i. Establishing effective response plan j. Assigning staff to limit type-2 violence 12. Procedures for post-incident response and investigation a. Providing medical care for injured employees b. Identifying employees involved in incident c. Providing trauma counseling d. Conducting post-incident debriefing e. Reviewing patient-specific risk factors f. Reviewing whether corrective measures were implemented g. Soliciting affected employees about their opinions on incident d. Violent Incident Log i. General guidelines: The employer shall record information in a violent incident log (Log) about every incident, post-incident response, and workplace violence injury investigation. Information should be solicited from the employees who experienced the workplace violence. Omit any element of personal identifying information. The Log should be reviewed during the annual review of the Plan. ii. Each incident report must include: 1. Date, time, location, department 2. Detailed description 3. Classification of who perpetrated violence 4. Classification of circumstances 5. Classification of location 6. Type of incident 7. Consequences of incident 8. Information about person completing the log e. Review of Workplace Violence Prevention Plan i. General guidelines: performed at least annually, in conjunction with employees, problems will be corrected ii. Specifically, review must include: 1. Staffing 2. Security systems 3. Job design, equipment, and facilities 4. Risks associated with specific locations/units 5. The plan itself, accounting for: a. New or modified tasks based on changes in staffing, etc. b. Newly recognized hazards c. Review and evaluate serious incidents d. Review and respond to information indicating that the plan is deficient f. Training i. General training requirements ii. Initial training when plan is first established, including: 1. An explanation of workplace violence prevention plan 2. How to recognize the potential for violence and risk factors 3. Strategies to avoid physical harm 4. How to recognize alarms/alerts and use evacuation routes 5. The role of private security personnel, if any 6. How to report violence to law enforcement 7. Resources available for coping with workplace violence 8. Opportunity for questions and answers iii. Additional training will be given when changes are made to violence prevention plan iv. Training not given in-person is acceptable v. Refresher training will be given at least annually vi. Additional training is required for employees assigned to respond to violence or to confront or control violent persons, including 1. General and personal safety measures 2. Aggression and violence predicting factors 3. The assault cycle 4. Characteristics of violent patients 5. Verbal intervention and de-escalation techniques 6. Strategies to prevent physical harm 7. Appropriate and inappropriate use of restraining techniques 8. Appropriate and inappropriate use of medications as chemical restraints 9. An opportunity to practice maneuvers and techniques g. Recordkeeping i. Records of workplace violence hazard identification, evaluation, and correction shall be created and maintained. ii. Training records shall be created and maintained for a minimum of one year and include training dates, contents or a summary of the training sessions, names and qualifications of persons conducting the training, and names and job titles of all persons attending the training sessions. iii. Records of violent incidents, including but not limited to, violent incident logs, reports, and workplace violence injury, shall be maintained for a minimum of five years. These records shall not contain “medical information.” iv. All records shall be made available to the Chief on request for examination and copying. v. All records shall be made available to employees and their representatives, on request, for examination and copying. h. Hospitals are required to report serious workplace violence incidents to Cal OSHA IV. Leadership Obligations when Violence is Reported a. Empowering Employees i. Employees’ right to safe work environment (including legal ramifications to you) ii. Taking all reported incidents seriously iii. Deterrents to reporting workplace violence, including fear of reprisal or perception of poor performance, and sentiment that violence is part of the job iv. Ensuring employees understand their responsibility to report workplace violence v. Creating a “just culture” — changing systems rather than punishing individuals vi. The importance of visibility — in policy, investigation, and response b. Investigating a Report of Workplace Violence i. The importance of an effective investigation (future safety and legal liability) ii. Reviewing the components of an investigation required by law iii. The basic logistics of the investigation process 1. Move quickly, be thorough, maintain confidentiality 2. Who conducts the investigation? 3. Identifying the purpose of the investigation 4. Maintaining objectivity 5. Witnesses — identifying them and determining their credibility 6. Gathering documents and evidence 7. Taking Interim steps 8. Talking to participants 9. What kinds of questions to ask and how to ask them c. Enacting corrective measures i. Following up and debriefing with affected employees ii. Reviewing and adjusting policies and procedures iii. Addressing employee concerns about staffing iv. Updating training V. Preventing Workplace Violence a. Management Commitment and Employee Involvement i. Setting an example through leadership, rewarding proactive behavior ii. Establishing a culture of safety iii. Collective mindfulness iv. “Tapping out” v. Little changes with big consequences (language adjustments, team building) vi. Holding employees to a high code o
Holly Carlson, MS, RN, CCRN, was a subject matter expert for Relias. She has 25 years of healthcare experience in both acute and post-acute healthcare environments. Her experience includes leadership and management across the healthcare spectrum. She has owned and operated an assisted living business. Carlson's clinical practice includes acute care, long-term acute care, home health and hospice. Carlson has served for over a decade in various board positions for State Nursing Associations, including president. She has been a nurse planner for multiple continuing education events and has experience as a leader in the design and implementation of an ANCC-CNE accredited approver unit for a multi-state nursing consortium. Carlson is certified as Critical Care Registered Nurse. Disclosure: Holly Carlson, MS, RN, CCRN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.Instructor: Eric Chalfant, PhD
Dr. Eric Chalfant is a professional researcher and author with a PhD in religious studies from Duke University. He honed his research skills as a nationally-ranked collegiate policy debater and debate coach at Whitman College. In addition to his work for OnCourse Learning, Eric has contributed to Duke University's National Congregation Study and has edited and published scholarly works for Oxford University Press. Disclosure: Eric Chalfant, PhD has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.