Arizona VA Healthcare System Failed to Protect Employees from Potentially Deadly Violence

For the second time in four years, federal investigators have determined that an Arizona veterans’ medical center failed to protect healthcare workers from unit residents who kicked, bit, struck, punched, slapped, and sexually harassed them, the US Department of Labor (DOL) announced on July 2, 2024.

In December 2023, the DOL’s Occupational Safety and Health Administration (OSHA) concluded that the medical center again exposed nurses, nursing assistants, and housekeeping staff to patient violence. Federal regulations require employers to provide a workplace free of hazards that are causing or are likely to cause employees to suffer serious physical harm or worse. Had the facility been a private sector employer, the agency could have assessed penalties up to $161,323.

“Healthcare industry workers encounter workplace violence up to four times more often than people employed in private industry,” said OSHA Area Director Zachary Barnett in Phoenix, Arizona. “The failure of the [the medical center] to prevent the same dangers that existed in 2019 is troubling. The facility’s management must take immediate action to better protect its employees from workplace violence before someone is seriously hurt or even killed in an incident that they could have prevented.”

The Centers for Disease Control and Prevention (CDC) estimate that people employed in hospitals fall victim to non-fatal workplace assaults at a rate of 8.3 per 10,000 workers, significantly higher than 2.0 per 10,000 workers’ rate for those employed in all private sector industries.

OSHA’s Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers can be accessed here.

Compliance Perspective

Issue

Healthcare and social service workers face an increased risk of work-related assaults resulting primarily from violent behavior of their patients, clients, and/or residents. While no specific diagnosis or type of patient predicts future violence, epidemiological studies consistently demonstrate that inpatient and acute psychiatric services, geriatric long-term care settings, high volume urban emergency departments, and residential and day social services present the highest risks. Pain, devastating prognoses, unfamiliar surroundings, mind- and mood-altering medications and drugs, and disease progression can also cause agitation and violent behaviors. The General Duty Clause from the OSHA Act of 1970 requires that, in addition to compliance with hazard-specific standards, all employers provide a work environment “free from recognized hazards that are causing or are likely to cause death or serious physical harm.”

Discussion Points

    • Review policies and procedures related to risk management and preventing workplace violence. Ensure that the policies and procedures incorporate OSHA’s guidelines and standards that are designed to support a safe working environment.
    • Train staff on your policies and procedures related to preventing workplace violence. Ensure that all leadership staff are knowledgeable of OSHA’s guidelines and standards for a safe working environment. Staff should know that reporting any concerns is mandatory, and could save a life or prevent serious injury. Hold mock drills that include participation of law enforcement and other first responders to assess the effectiveness and competence of staff in responding to emergency situations, and provide information to residents and responsible parties through your usual communication modalities. Document these actions thoroughly.
    • Periodically audit to ensure that staff are trained and knowledgeable of the OSHA guidance provided in your policies and procedures related to all categories of workplace violence, and that these protocols are being followed. Also audit to ensure that staff are aware of their duty to report any concerns to their supervisor, the compliance officer, or via the anonymous hotline.

*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*

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