Resources: Risk of Violence/Danger to Others
Relevant Standards
- CMS: B104, B108, B113, B115,
- TJC: LD.03.01.01, LD.04.04.05, PC.01.02.01- 05,
References & Tools
- Psychiatric Violence Risk Assessment[®]: Am J Psychiatry 2012;169:340-340. 10.1176/appi.ajp.2012.169.3.340
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Violence in Healthcare Facilities[®] – Healthcare Risk Control, Vol 2, March, 2011, ECRI Institute
- Preventing violence in the health care setting[®] – TJC Sentinel Event Alert, Issue 45, June 3, 2010
- The Macarthur Violence Risk Assessment Study[®] – September 2005 Update of the Executive Summary,
- OSHA’s Guidelines for Preventing Workplace Violence for,Health Care & Social Service Workers [PDF][®] OSHA 3148-01R 2004
- Tools:
- Program Specific Tracer – Violence in TJC Survey Activity Guide
- WPS Aggresion Questionnaire[®] – self-report inventory for screening children and adults for aggressive tendencies Overview/Description Sample
- Violence Risk Factors/Assessment Summary (PDF)
Required Written Documents
- PC.01.02.01, EPs 1, 2
- PC.01.02.03, EP 1
** Additional Clarifications & Compliance Strategies (Premier)**
[private Membership premier]
• Sentinel Events: Preventing Violence in the Health Care Setting [REF: SFT, SEC, HR, LDR, GB, MDx, RNx, JCSC], Perspectiveson Patient Safety, September 2011, Volume 11, Issue 9, Pg 06
This article is essentially a repeat of similar TJC articles from last year that encouraged facilities to plan and assess (e.g., violence mock tracer) for the possibility of violence not just by patients, but also by upset staff or community members. The article also repeats TJC’s recommendations that are culled from Sentinel Event Alert 45: Preventing violence in the health care setting. If you did not read this alert when it was released in
June, 2010, you should do so and/or see our review of Sentinel Event Alert: Preventing Violence in the Health Care Setting – July Perspectives, July 2010, Vol30, #7, pg 7.
• Sentinel Event Alert: Preventing Violence in the Health Care Setting [REF: SFT, SEC, HR, LDR, GB, JCSC] Perspectives, July 2010, Volume 30, Issue 7, Pg 07
This alert was issued on 6/3/10 and reviewed in our June Newsletter. The article is essentially a reprint of the Alert 45. However, it informs us that TJC’s sentinel event database has been receiving increasing reports of assault, rape and homicide since 2004. In that context it is worth noting that leadership, human resources and the quality of assessments (e.g.,psychiatric assessments ) and communication failures are identified as causal factors in over half of such reports. As part of the approach to prevention, hospitals are encouraged to identify the high risk areas for such violence (especially areas of relatively high stress and high traffic) and to screen more rigorously e.g., take background checks more seriously) for the identification of staff who might be potential perpetrators. [PEARL: SFT, RM, PI] The alert also identifies a non-profit research organization called the ECRI Institute and a reference article published by them, entitled, “Violence in Healthcare Facilities“. This 2005 ECRI Risk Analysis provides valuable guidance for violence prevention. Some of the strategies include conducting a violence walk-thru and performing a violence audit. There are also recommendations for violence
management training and how to respond after a violent incident. See also:
• The Violence Tracer: A Behavioral Health Care Requirement That Can Also Benefit Other Settings[®] Environment of Care® News, March 2010, Volume 13, Issue 3 [Ftxt available via TJC Connect]:
FYI: JCSC, LDR. This is the same article printed earlier in The Source, July, 2009 under the title Tracer Methodology 101:The Violence Tracer.
• Tracer Methodology 101: The Violence Tracer[®] The Source, July 2009, Volume 7, Issue 7
[•• REF••] Although the Violence Tracer is a program-specific tracer for behavioral health care programs, it (or a variant thereof) can be triggered in any setting. JCSC and LDR would be wise to incorporate this tracer into your survey preparations (e.g., practice tracers) and use it as a PI tool to help assess and improve the management
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