When we consider the working conditions of healthcare workers, we think about underfunding, long shifts and too many patients in the care of too few staff members. But one thing that often escapes our attention is violence against healthcare workers. A study published earlier this year in the New England Journal of Medicine revealed that 46 percent of American nurses reported violence in one of their most recent five shifts, and one in three were physically assaulted. The statistics are similar in Canada, and, in fact, the number of reported events in Ontario have been increasing over the last five years.
The Public Services Health & Safety Association (PSHSA) is working to change that with the Violence, Aggression and Responsive Behaviour (VARB) project. The goal of the project is to give workplaces practical tools and a consistent model to reduce the incidences of violence in healthcare. The project is being completed in several phases, and the first part to be completed is the Flagging Handbook. This handbook, which will be offered free to all healthcare workplaces in Ontario, gives guidelines for flagging patients who have had a history of violence or exhibit behaviours that indicate they have the potential to become violent. By alerting healthcare staff ahead of time, the hope is that they can take measures to help prevent the violent acts from happening.
However, the approach requires careful consideration, according to Henrietta Van hulle of PSHSA. There are several questions that need to be asked before a flagging policy is introduced. First, what would cause a patient to be flagged? Does a history of violence, under any circumstances qualify, and how violent must the patient be? Second, do you flag the person’s chart, or use a wristband, which then allows anyone to know the patient’s private status? Third, how do we ensure that the flagged patient does not get a lower level of care than one who is not flagged? Finally, is there evidence that flagging patients reduces the number of assaults on staff?
The answer to the last question appears to be yes, according to Van hulle. She says that several large hospitals have reported that flagging appears to be helping. PSHSA will be reviewing the toolkit and making changes based on feedback during the next phase of the VARB project. The results will hopefully create a safer, violence-free workplace for all Ontario healthcare workers.
Public Services Health & Safety Association (PSHSA) works with Ontario’s public and broader public sector workers and employers, providing occupational health and safety training, resources and consulting to reduce workplace risks and prevent workplace injuries and illnesses.
For more information, visit www.pshsa.ca.
To download the Flagging Toolkit, click here
