Workplace Violence and Aggression Minimization Strategies

Nurses working in Al Masarra Hospital, a tertiary psychiatric facility in the Sultanate of Oman being at the frontline are at high risk of exposure to workplace violence and aggression. Based on the 2015 Annual Report of Clinical Incidents, 17% of reported events are related to security issues specifically assault by patient, attendant or visitor. Nurses being at the front line of the healthcare profession sought to develop a framework of care which contains the principles for safe and effective management of disturbed and aggressive behaviour within Al Masarra Hospital, with the view to promote the reduction and, where possible, elimination of the use of manual / mechanical restraint within the facility and works on possible ways to collaboratively address this problem. Furthermore, this has been identified through risk assessment and Analysis of reported incidents related to safety and security issues in order to identify critical or high risk areas which require special strategic implementation of a Workplace Violence and Aggression Minimization Plan.

A safer approach to managing the care of patients who exhibit disturbed or aggressive behaviour is a primordial focus on coming up with the strategies. This approach is likely to have a better outcome for staff and patients. These minimization strategies cover 7 Domains as follows: 1. Safety Briefing of Staff on Potentially Safety hazards or threats conducted in every Handover/endorsement. This increases staff awareness of patient safety issues, creates an environment in which staff share information without fear of repercussions from the hospital administration, and integrate the reporting of safety issues into daily clinical work in every Nursing Handover 2. Risk assessment and management of triggers or stimuli of aggressive events 3.Use of De-escalation technique as part of on-going communication and engagement with the patient and their family as part of care planning. 4. Case Management and implementation of a Code White Response System as part of behavioural crisis management interventions. 5. Creation of a Simulation Based Mandatory Course on Personal Safety and Aggression Management based on Ethical Care Control and Restraint (UK) Ltd. Standards. 6. Code White Drills as part of staff professional competency improvement and development. 7. Post Incident Management through Incident reviews, Debriefing and case reflections.

With the incessant implementation of the strategies, it is projected that there will be a decreased on assault of patient, attendant or visitor reported incidents by the end of 2017. Indeed, positive and proactive care is the main approach to patient care, using restrictive interventions has always been the last resort in the treatment options. Treating patients with dignity, compassion and respect are the core values of the management.