BEST PRACTICE POST ASSAULT
Employers have a duty of care towards employees to ensure that they are not harmed in any way by work activity. If violent incidents occur the effects should be minimised.
Long-term effects may include reduced morale, impaired performance, absenteeism, increased sick leave and the psychological trauma suffered by the people involved in the incident.
The employer should have:
- documented procedures for prevention and early intervention strategies, as soon as an assault or the potential for an assault is identified
- procedures in place to be followed for an effective immediate response that controls and diffuses the situation
- access to a debriefing session if required
- a rehabilitation assessment that considers:
- time frames for interventions
- the responsibilities of those involved
- the methods for assessing needs
- A process to ensure that referrals are made to the relevant service providers for the appropriate treatment
Prevention procedures include:
- Provision of a suitable work environment to minimise risk
- Behaviour management plans for clients
- Staff training in behaviour management and defusing techniques
- Safe place to retreat to and emergency communication systems.
Procedures for responding to incidents should
-Describe the circumstances in which the procedures should be followed;
-Describe the role of the individual members of staff
-Nominate an individual to co-ordinate response action
-Control media access to those involved
-Provide communication with families and arrange transport home
-Give clear guidance on reporting procedures
-Indicate follow up actions, including staff debriefing and counselling as appropriate
-Consider referral to employee assistance programmes to provide psychological first aid support.
Be aware of different people's reaction to a stressful situation. These may include: feelings of anger, frustration, anxiety, guilt, embarrassment and of being "out of control". They may respond inappropriately and have physical symptoms such as vomiting. Longer term, they may suffer with sleeplessness, "reliving the event", and a fear of returning to work. These reactions should be recognised and managed quickly after the episode to reduce the risk of psychological harm.
Reporting
-Employee details
-Location of incident
-Date, day and time
-Details of the assailant
-What the employee was doing at the time of the incident
-The circumstances of the assault
-Details of the outcome: i.e. injuries received, time off work, property damage
-Information about any remedial action
Medical Treatment
-When a caregiver reports being assaulted and/or injured in the course of his or her work, the employer should assess the injury, provide first aid treatment if required, and facilitate any short- or long-term medical treatment that is necessary.
-Provision needs to be made for workers to be able to summon help quickly
-Plans/arrangements may be necessary with local medical care facilities for urgent consultations in cases of injuries
-A treatment plan or provider network should be established in advance, not only to deal with any physical injuries but also to provide a treatment plan for any psychological or mental health issues that might arise from a workplace incident
Debriefing
-Sharing personal experience with others to diffuse the impact of abuse
-Helping those who have been affected understand and come to terms with the event
-Re-assurance and support
-Getting people to focus on the facts and give information
-Explaining subsequent help available
Counselling
- Face to face contact - preferably short term of between 5-8 sessions
- Response to traumatic incidents:
- Defusing and debriefing
- helping staff to come to terms with what has happened
- offering re-assurance and support
- getting people to focus on the facts and give information
- explain the subsequent help an available
- Post Trauma counselling
- For staff who need more intensive support or when symptoms persist over a long period
- Integration of cognitive strategies into the decision making process
- Links to outside services. Arrangements need to be made for staff to have access to external advice where the full range of services is not available in-house. Written protocols for these services should cover accessibility
Management support
-Taking control of situation, informing others and dealing with victims and other staff
-Producing organisational and administrative policies aimed at minimising the impact of traumatic events which cover areas such as post incident support, provision of leave, costs, legal issues, etc.
-Provision of information to families and the media, expressions of gratitude to staff and investigatory procedures
-Provide a structured feedback program with workplace staff incorporating better awareness of risk situations for violence, how potentially dangerous situations could be avoided and review strategies in dealing with aggressive clients
Return to Work
Best practice RTW policies, procedures and responsibilities include:
-Early intervention
-A strong management commitment to RTW including the provision of safe modified duties during the recovery phase
-The early development of RTW plans in face-to-face interviews with the injured employee
-A supportive and consultative workplace culture for injured employees, including the provision and support for modified work and reduced hours of work in the short term
-Consideration of training and vocational needs
-Workers should be supported during the entire period of RTW, allowed all necessary time to recover but also encouraged to return to work
-The sooner the victim can return to work, the easier it would be for him/her to rejoin the workplace as the worker may have missed out on the current information needed for effective job performance
-Workers should not besubjected to too much stress at first and flexibility in the form of part time work, a different assignment &/or support of a co-worker can allow the person to recover their self-confidence
-It is important that, when they return to work, they feel safe in theirenvironment both from physical and psychological violence
-the feedback into hazard management of issues arising out of the rehabilitation process
References
Arnetz, J & Arnetz, B. (2000) Implementation and evaluation of a practical intervention programme for dealing with violence towards health care workers. Journal of Advanced Nursing.Vol 31, issue 3, pages 668-680
NZ Ministry of Business, Innovation & Employment.Managing the risk of Workplace Violence to Healthcare and Community Service Providers (
Richards, J. (2003). Management of workplace violence victims. Available from:
International Labour Office/International Council of Nurses & World
Health Organization/Public Services International.(2003). Framework guidelines for addressing workplace violence in the health sector. Available from: