Developing and Implementing a Patient Behaviour Risk Screening, Communication and Care Planning Intervention for Hospital Settings.

Workplace violence prevention of patient behaviours is a primary safety focus in hospital settings. In response to provincial mandates, a multi-site tertiary care hospital system developed the Behaviour Safety Risk Communication and Care Planning Program. Components include patient risk screening, communication tools and care plans that outline mitigation strategies. The program has been implemented at six sites using the following strategies: educational and planning meetings, formation of steering committees, identification of champions, educational materials/training, facilitation and consultation, and audit and feedback. Our paper can guide program development and implementation in similar contexts.

Factors associated with physical injury or police involvement during incidents of workplace violence in hospitals: Findings from the first year of California's new standard.

BACKGROUND: Workplace violence in healthcare settings is known to be a costly and often underreported problem. In California, hospitals are required to report incidents of violence towards workers to the California Occupational Safety and Health Administration (CalOSHA) using an online reporting system that went into effect in 2017. METHODS: Reports submitted to CalOSHA from July 2017 to September 2018 pursuant to this new requirement were analyzed using descriptive methods and logistic regression. RESULTS: Four hundred eight hospitals submitted reports using the new incident reporting system. Behavioral health units had 1.82 times the odds of the reported incident resulting in physical injury compared to inpatient medical units, and investor-owned facilities had 2.43 times the odds of the reported incident resulting in physical injury compared to city or county-owned facilities. Inpatient and behavioral health units had significantly reduced odds of a reported incident resulting in police involvement when compared to other locations within the hospital. CONCLUSIONS: These findings indicate that protections for healthcare workers deserve ongoing attention from stakeholders and legislators and provide insight into how healthcare facilities report incidents of violence towards workers.

"Felony assault should stick:" Assaulted EMS responders' frustration and dissatisfaction with the legal system.

INTRODUCTION: The prevalence of violence to first responders is reported in ranges of approximately 40% to 90%. Pennsylvania has a felonious assault statute to address such violence, but the prosecutorial process has been noted to cause first-responder dissatisfaction. METHODS: An exploratory qualitative study using individual interviews with snowball sampling was conducted with the Philadelphia District Attorney's office to understand the prosecutorial process when a first responder is assaulted and injured in a line of duty. The Philadelphia Fire Department provided a list of first responders who sustained a work-related injury from a patient or bystander assault so that particular cases could be discussed during the interviews. RESULTS: Emergent themes fell into two categories: factors that lead to a charge (prosecutorial merit, intent, and victim investment), and the judge's discretion in sentencing ("part of the job" mentality, concern for the defendant, and the justice system's offender focus). Immediately actionable tertiary prevention recommendations for fire departments, labor unions, and district attorney's offices were developed. CONCLUSION: Violence against fire-based emergency medical service (EMS) responders is a persistent and preventable workplace hazard. While felonious assault statutes express society's value that it is unacceptable to harm a first responder, this study found that such statutes failed to provide satisfaction to victims and that support when going through the court process is lacking. Assaulted EMS responders, their employers, and labor unions would benefit from the recommendations provided herein to help them extract a stronger sense of procedural justice from the legal process.

Increased maximum sentences for assaulting nurses.

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the provisions of the Assaults on Emergency Workers (Offences) Act 2018.

Social Security Administration Violence Evaluation and Reporting System. Final rule.

We are issuing a final rule to exempt a system of records entitled Social Security Administration Violence Evaluation and Reporting System (SSAvers) from certain provisions of the Privacy Act because this system will contain investigatory material compiled for law enforcement purposes.

[Legal Viewpoints on Violence in the Emergency Department].

Medical violence is on an upward trend. The aim of this article is to investigate the role of Taiwan's national legislature under the Medical Act with regard to preventing and managing violence. Because legal protection is limited, we recommend that all healthcare institutes and their staffs continually pay attention to the strategies of violence prevention and keep an eye on high-risk groups and the appearance of pre-event aura. When a violence event occurs, involved persons should resolutely activate the rapid response team and report the event to the healthcare and prosecuting authorities immediately. Furthermore, institutes should provide all necessary resources such as psychological support and legal assistance in order to minimize harm to staffs.

LBC petition fails to prompt law change.

A petition signed by more than 116,000 people has failed to convince the government that a new law is needed to deal specifically with assaults on NHS staff.

Government seeks to replace NHS Protect.

NHS Protect, which leads on safeguarding NHS staff and resources from crime, is reported to be ending its work at the end of March, according to the BBC.

Workplace violence and hospital security programs: regulatory compliance, program benchmarks, innovative strategies.

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.

Gender-based violence against female sex workers in Cameroon: prevalence and associations with sexual HIV risk and access to health services and justice.

BACKGROUND/OBJECTIVES: Female sex workers (FSWs) are at risk for HIV and physical and sexual gender-based violence (GBV). We describe the prevalence of lifetime GBV and its associations with HIV risk behaviour, access to health services and barriers in accessing justice among FSWs in Cameroon. METHODS: FSWs (n=1817) were recruited for a cross-sectional study through snowball sampling in seven cities in Cameroon. We examined associations of lifetime GBV with key outcomes via adjusted logistic regression models. RESULTS: Overall, 60% (1098/1817) had experienced physical or sexual violence in their lifetime. GBV was associated with inconsistent condom use with clients (adjusted OR (AOR) 1.49, 95% CI 1.18 to 1.87), being offered more money for condomless sex (AOR 2.09, 95% CI 1.56 to 2.79), having had a condom slip or break (AOR 1.53, 95% CI 1.25 to 1.87) and difficulty suggesting condoms with non-paying partners (AOR 1.47, 95% CI 1.16 to 1.87). Violence was also associated with fear of health services (AOR 2.25, 95% CI 1.61 to 3.16) and mistreatment in a health centre (AOR 1.66, 95% CI 1.01 to 2.73). Access to justice was constrained for FSWs with a GBV history, specifically feeling that police did not protect them (AOR 1.41, 95% CI 1.12 to 1.78). DISCUSSION: Among FSWs in Cameroon, violence is prevalent and undermines HIV prevention and access to healthcare and justice. Violence is highly relevant to FSWs' ability to successfully negotiate condom use and engage in healthcare. In this setting of criminalised sex work, an integrated, multisectoral GBV-HIV strategy that attends to structural risk is needed to enhance safety, HIV prevention and access to care and justice.

Workplace violence in healthcare: strategies for advocacy.

The Occupational Safety and Health Administration (OSHA) reports that over 2 million American workers are victims of workplace violence each year. Violence can strike any workplace; no area is immune. But who may be more at risk? Commonly, violence occurs at work and refers to a broad spectrum of behaviors (e.g., violent acts by patients, visitors, and/or coworkers) that result in a concern for personal safety. This article provides a brief overview of workplace violence, and discusses the settings where it often occurs. The authors consider the direct and indirect financial impact of violent acts, such as jury awards for injuries; higher than average turnover; increased requests for medical leaves; unusually high time and attendance issues; and stress related illnesses. Advocacy strategies for nurses are offered to address workplace violence on several levels, such as legislative advocacy, workplace policy, and education.