Preventing Workplace Violence in Nursing Facilities

Staff members can prevent nursing home violence by learning to work with cognitively impaired residents.
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Many nursing home employees endure assaults during their shifts. These attacks often involve a cognitively impaired resident who physically lashes out at a worker during close contact activities such as bathing or dressing, according to the American Geriatrics Society's Annals of Long-Term Care: Clinical Care and Aging. During a typical episode, the patient grabs, bites or hits the employee. Preventing workplace violence in these facilities focuses on managing a dementia resident’s level of agitation before it turns into aggression toward staff or other patients.


Employees at nursing facilities can reduce workplace violence by ensuring their cognitively impaired residents engage in daily activities, says. These events become helpful distractions that reduce residents' levels of agitation, which can trigger destructive outbursts. Suitable activities include music, pet therapy, gardening, crafts or exercise. Supervised walks outdoors also are therapeutic. Programs should be designed for adults, not children.


Many nursing home employees fail to report assaults committed by residents, which hinders authorities’ efforts to prevent such outbreaks, according to the U.S. Department of Labor Occupational Safety and Health Administration. OSHA attributes this poor tracking to several factors. Some staff members believe that residents’ inappropriate behaviors are standard occupational hazards. Employees might worry about being accused of patient abuse or incompetence if they speak up. They might dread the paperwork involved in documenting an assault. Some facilities fail to establish and train workers on how to record violent episodes so that administrators can take steps to avert future attacks.


Staff members in nursing facilities should meet regularly to review current information on residents who have histories of violence. This ongoing assessment covers all of a resident's medications, any recent outbursts and progress made in improving behaviors. These ongoing sessions help assess any risks so that staff members can be ready to intervene instead of waiting until after a violent incident occurs.


Nursing professionals require training to manage residents’ behaviors. Certified nursing assistants interact most frequently with nursing home residents, which leaves CNAs vulnerable to assaults, according to the Annals of Long-Term Care: Clinical Care and Aging. CNAs who complete training on managing behaviors use fewer physical or chemical restraints on agitated patients than their peers who haven't undergone coaching. These nursing staff members rely on eye contact and positive affirmations. They know how to effectively work with cognitively impaired residents by allowing them time to respond to commands without feeling overwhelmed or panicked, which can set off an assault.

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