TABLE 1.

Checklist of suggested prevention strategies for workplace violence on hospital units

ENVIRONMENTAL
ENTRIES/EXITS
□Are there enough exits and adequate routes of escape? □Can exit doors be opened only from the inside to prevent unauthorized entry? □Is access to work areas only through a reception area? □Are reception and work areas designed to prevent unauthorized entry? □Are there security guards at the entrances and/or exits of the unit? □Are there metal detectors at the entrances of the unit?
WORK AREA HAZARDS
□Are waiting and work areas free of objects that could be used as weapons? □Are chairs and furniture secured to prevent use as weapons? □Is furniture in waiting and work areas arranged to prevent employees from becoming trapped? □Are hallways and work areas clear of obstacles that block pathways?
WORKPLACE DESIGN
□Could someone hear a worker call for help? □Is there appropriate lighting used in patient areas? (brightly lit, dim during sleeping times) □Is there an appropriate noise level in patient areas? □Can workers observe patients or clients in waiting areas and rooms from their work stations? □Are patient or client areas designed to maximize comfort and minimize stress? □Are there employee-only work areas that are separate from public areas? □Is a secure place available for employees to store their personal belongings? □Are private, locked restrooms available for staff?
SECURITY MEASURES
□Are emergency phone numbers programmed into phones? (i.e. security) □Do workers have easy access to telephones? □Are there security cameras in the unit? □Are there functional alarms/panic buttons?
ADMINISTRATIVE
POLICIES RELATED TO WORKPLACE VIOLENCE
□Is a “zero tolerance” policy for violence clearly communicated to both employees and patients through verbal or posted cues? □Is there a written workplace violence prevention program in your facility? □Is there someone responsible for the violence prevention program to ensure that all managers, supervisors, and employees understand their obligations? □Are there emergency procedures in place for violent events? □Are there well-communicated consequences for employees who engage in Type III violence? □Are workers instructed to report suspicious or threatening activity? □Are workers encouraged to report violent incidents?
SAFETY PROCEDURES
□Is there someone responsible for building security? □Are there trained security personnel accessible to workers in a timely manner? □Are workers told who is responsible for security? □Is there adequate staffing available at all times to protect or aid workers against assaults or other violence? □Is there a “buddy system” for when workers are in potentially dangerous situations? □Do security personnel have sufficient authority to take all necessary action to ensure worker safety?
STAFFING
□Do workers have at least one other employee on the unit with them on each shift? □Is there adequate staffing for transfers, emergency situations, and extra-role work tasks? (taking time away from routine patient care) □Are there regular visiting hours with proper monitoring/number of staff at these times?
WORK ROUTINES AND RESOURCES
□Is there a system in place for sharing limited equipment? □Are there specific, communicated guidelines in place for “float staff” (e.g. respiratory therapists) and how staff should share the facility with them? □Are incidents of workplace violence reviewed?
BEHAVIORAL
STAFF KNOWLEDGE
□Are workers informed about incidents of workplace violence on their unit? □Are workers up to date on ethical and legal issues for workplace violence? □Are workers made aware of unit policies for violence as they are updated?
STAFF SKILLS
□Are workers trained to respond to violent situations involving patients? □Are workers trained in ways to prevent or defuse potentially violent situations? □Are workers trained in personal safety and self-defense? □Are workers trained in conflict resolution? □Are workers trained in the emergency response plan (for example, escape routes, notifying the proper authorities)? □Are workers trained to report violent incidents or threats?
STAFF PROFESSIONAL BEHAVIOR
□Are there trained employees who could mediate conflict between coworkers? □Are workers trained to promote respectful treatment among coworkers?