| Inspection Type |
Complaint
|
| Scope |
Partial
|
| Safety/Health |
Health
|
| Close Conference |
2018-01-19
|
| Emphasis |
L: Violence
|
| Case Closed |
2018-07-02
|
Related Activity
| Type |
Complaint |
| Activity Nr |
1243194 |
| Safety |
Yes |
|
| Type |
Complaint |
| Activity Nr |
1296124 |
| Safety |
Yes |
|
Violation Items
| Citation ID |
01001 |
| Citaton Type |
Serious |
| Standard Cited |
5A0001 |
| Issuance Date |
2018-01-29 |
| Abatement Due Date |
2018-08-30 |
| Current Penalty |
5500.0 |
| Initial Penalty |
9054.0 |
| Final Order |
2018-02-21 |
| Nr Instances |
12 |
| Nr Exposed |
18 |
| Gravity |
10 |
| FTA Current Penalty |
0.0 |
| Citation text line |
OSH ACT of 1970 Section (5)(a)(1): The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that employees were exposed to physical threats and assaults by residents: a) On or about August 7, 2017, and at times prior, the employer, 12th Street Operations LLC d/b/a Pioneer Health Care Center failed to keep the workplace free of hazards. Certified Nursing Assistants (CNA?s), were exposed to incidents of violent behavior by residents that have resulted in bites, sprains, broken skin, bruising, scratches, soft tissue trauma, and injuries to the head and torso from punches, kicks, and forceful grabs. Among other methods, feasible and acceptable means to abate the workplace violence hazards at Pioneer include development and implementation of a comprehensive and effective workplace violence prevention (WPV) program which includes engineering and administrative controls, as well as training to materially reduce workplace violence hazards. These controls include: Engineering and Work Practice Controls: 1) Install security cameras in common areas. 2) Provide two-way radios and personal panic alarms for the CNAs and other staff who may be in close proximity to residents who have exhibited violent behavior, in order to rapidly and reliably summon assistance to minimize or eliminate employee injury from workplace violence. In addition, provide training on use and limitations of the equipment. 3) Encourage staff to secure loose hair so that it is not accessible to residents, to minimize the risk of neck strains and hair pull injuries. 4) Remove unsecured items (i.e. glass cups, bowls, and metal silverware) to prevent the items from becoming a weapon for the resident to use against employees. When appropriate, make sure furniture is bolted to the floor to prevent residents from using them as a weapon. Training: 5) Conduct site specific training for all employees so they are aware of the specific hazards and relevant means to protect themselves and coworkers. The training should include what procedures and practices to follow in the workplace, including elements on how to anticipate and respond appropriately to de-escalate an agitated client and to utilize other techniques when de-escalation is not effective in order to avoid being injured. 6) Conduct the site specific training at the beginning of employment, when significant changes are made to the policies and/or procedures and annually thereafter. 7) Conduct training to ensure employees report all assaults or threats to a supervisor or manager, (for example, through a confidential interview). Keep logbooks and reports of such incidents to help determine any necessary actions to prevent recurrences. Establish a liaison with local police and service providers who can assist (e.g., counselors). When needed, give police physical layouts of facilities to expedite investigations. Administrative Controls: 8) Develop and communicate written policy and procedures regarding potential violence in the workplace to employees. The policy must clearly define workplace violence hazards employees may encounter including, but not limited to, verbal and physical assaults and assign oversight and prevention responsibilities to appropriate staff. 9) Ensure the resident to staff ratio on all shifts is in accordance with state regulations, and is adequate to handle incidents of violent behavior. Also, ensure that if staff are assigned to respond to calls for assistance they don?t have conflicting responsibilities. 10) Develop policy to determine when a buddy system should be implemented particularly for employees working alone with residents, such as resident quarters. 11) Establish a system to communicate to staff members any incident of workplace violence from the previous shift to ensure that the on-coming staff members are notified and aware of a resident?s previous acts of violence or aggression. Post Incident: 12) Investigate all workplace violence incidents resulting in a fatality, injury, or illness. Any near miss should be promptly investigated as well. Near misses are caused by the same conditions that produce more serious outcomes, and signal that some hazards are not being adequately controlled, or that previously unidentified hazards exist. Involve employees in the incident investigations and identify root causes. Implement appropriate recommendations resulting from incident investigations. Documenting and reviewing these incident investigations for trends or patterns will assist in identifying appropriate prevention and control measures. |
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