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| Workplace Violence in Healthcare and Examples of Behavioral Solutions |
| Saturday, May 25, 2024 |
| 5:00 PM–5:50 PM |
| Marriott Downtown, Level 3, Liberty Ballroom Salon BC |
| Area: OBM/AUT; Domain: Service Delivery |
| Chair: Oliver Wirth (CDC/NIOSH) |
| Abstract: This symposium addresses the topic of workplace violence (WPV), which is defined as violent acts including physical assaults and threats of assaults directed towards persons at work or on duty. Studies have shown an increasing trend in WPV against healthcare workers in the U.S. and abroad. Despite these increases, it is widely acknowledged that cases of WPV are still under-reported due to various organizational and individual factors suggesting that we do not know the full extent of the problem. This is especially true of applied behavior analysts, who are responsible for planning and implementing behavior-focused treatments in schools, clinics, homes, and hospitals. These treatments are often designed to reduce violent, aggressive, and destructive behaviors, and the nature of this work can require ABA workers to evoke and directly confront violent and aggressive behaviors, causing significant risks for injury and psychosocial stress. To highlight these concerns, this symposium will: (1) define the various types of workplace violence, highlight current statistics on incident rates and prevalence, and summarize OSHA guidelines and other common strategies for addressing WPV in healthcare settings; (2) identify organization-, process-, and job-level factors that will aid workplace violence prevention efforts; and (3) provide examples of effective behavioral training solutions that provide healthcare workers the knowledge and skills needed to prevent and manage workplace violence incidents. |
| Instruction Level: Basic |
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| Workplace Violence Prevention: A Systems View |
| JONATHAN MARK HOCHMUTH (CDC/NIOSH), Oliver Wirth (CDC/NIOSH) |
| Abstract: Workplace violence (WPV) is defined as violent acts including physical assaults and threats of assaults directed towards persons at work or on duty. Studies have shown an increasing trend in WPV against healthcare workers in the U.S. and abroad. Despite these increases, it is widely acknowledged that cases of WPV are still under-reported due to various organizational and individual factors suggesting that we do not know the full extent of the problem. This is especially true of applied behavior analysts, who are responsible for planning and implementing behavior-focused treatments in schools, clinics, homes, and hospitals. These treatments are often designed to reduce violent, aggressive, and destructive behaviors, and the nature of this work can require applied behavior analysis workers to evoke and directly confront violent and aggressive behaviors, causing significant risks for injury and psychosocial stress. In this presentation, we will define the various types of workplace violence, highlight current statistics on incident rates and prevalence, and summarize OSHA guidelines and other common strategies for addressing WPV in healthcare settings. We also will highlight national research priorities on workplace violence and describe the status of relevant NIOSH research projects on the topic that aim to: (1) collect more information about the nature and extent of workplace injuries experienced by applied behavior analysis workers, and (2) identify organization-, process-, and job-level factors that will aid workplace violence prevention efforts. |
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| The Impact of Teaching Healthcare Workers Crisis Prevention Strategies Designed to Decrease Type 2 Workplace Violence |
| SETH B. CLARK (Marcus Autism Center), Nathan Call (Marcus Autism Center), Alec M Bernstein (Children's Mercy Kansas City; University of Missouri-Kansas City School of Medicine), Amy Pattishall (Emory University School of Medicine) |
| Abstract: Healthcare settings can often be associated with stressors and triggers that may ultimately lead to increased patient stress, agitation and crisis level behaviors. Staff working withing healthcare settings also frequently interact with patients who are currently in behavior health care crisis, further increasing the risk of potential workplace violence events. This ultimately can limit patients’ access to effective care and increase the need for restraints to safely manage behavior. The following study sought to examine if teaching healthcare staff basic strategies on how to prevent, identify, and de-escalate escalating behaviors can improve the quality of services provided to patients who are in behavior health care crisis, increase staff buy in, and decrease the use of restraint. The current study also sought to examine current perceptions and used of Behavioral Health Personal Protective Equipment (BHPPE). After completing behavioral skills training in crisis prevention strategies, staff completed pre/post measures assessing their confidence in supporting patients exhibiting crisis behaviors, their overall feeling of safety and risk of injury, and their ability to communicate during crisis. Results demonstrated significant improvement on this measure following training. Initial results also indicate decreases in restraint utilizations and improved awareness and reported use of BHPPE. |
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| Improving Provider Awareness and Preparedness for Autistic Patients in Emergency Departments |
| ABBEY HYE (Rady Children’s Hospital San Diego), Themba Carr (Rady Children’s Hospital San Diego; San Diego State University), Kathryn Hollenbach (Rady Children’s Hospital San Diego; University of California San Diego), Elizabeth Gallagher (Rady Children’s Hospital San Diego), Raquel Locsin (Rady Children’s Hospital San Diego), Abhi Dalal (Rady Children’s Hospital San Diego), Lauren Brookman-Frazee (University of California San Diego; San Diego State University; Rady Children’s Hospital San Diego) |
| Abstract: Autistic youth experience unique clinical concerns and consequently utilize emergency department (ED) health services more frequently than neurotypical youth. Autistic characteristics of sensory overload, anxiety, aversion to routine disruption, and misreading social cues can lead to increased crisis level behavior during ED visits. Providers’ lack of awareness and ineffective training are additional contributors to crisis level behavior in autistic patients in the medical setting (Slavatore et. al., 2022). In response, Rady Children’s Hospital implemented the Autism Friendly Health System Initiative (AFHSI) in the ED to decrease the likelihood of crisis level behavior via provider trainings and the introduction of the Autism Friendly Questionnaire (AFQ), a tool informing the use of proactive behavioral strategies to prevent patient escalations. The impact of training on ED providers’ awareness of and use of the AFQ was examined. Results indicated that ED providers reported increased awareness of the AFQ, readiness to support autistic patients, and adoption and acceptability of the AFQ in the ED setting. Dissemination of provider trainings and the AFQ across settings indicates promise for improving the quality of health service visits for autistic patients and providers. |
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