AN
ACT Relating to workplace safety in state hospitals; amending RCW 72.23.010;
adding new sections to chapter 72.23 RCW; creating a new section; and
prescribing penalties.
BE IT ENACTED BY THE
LEGISLATURE OF THE STATE OF WASHINGTON:
NEW
SECTION. Sec. 1. The
legislature finds that:
(1)
Workplace safety is of paramount importance in state hospitals for patients and
the staff that treat them;
(2)
Based on an analysis of workers' compensation claims, the department of labor
and industries reports that state hospital employees face high rates of
workplace violence in Washington state;
(3)
State hospital violence is often related to the nature of the patients served,
people who are both mentally ill and too dangerous for treatment in their home
community, and people whose behavior is driven by elements of mental illness
including desperation, confusion, delusion, or hallucination;
(4)
Patients and employees should be assured a reasonably safe and secure
environment in state hospitals;
(5)
The state hospitals have undertaken efforts to assure that patients and
employees are safe from violence, but additional personnel training and
appropriate safeguards may be needed to prevent workplace violence and minimize
the risk and dangers affecting people in state hospitals; and
(6)
Duplication and redundancy should be avoided so as to maximize resources
available for patient care.
Sec.
2. RCW
72.23.010 and 1981 c 136 s 99 are each amended to read as follows:
((As
used in this chapter, the following terms shall have the following meanings:))
The definitions in this section apply throughout this chapter, unless the
context clearly requires otherwise.
(1)
"Court" means the superior court of the state of Washington.
(2)
"Department" means the department of social and health services.
(3)
"Employee" means an employee as defined in RCW 49.17.020.
(4)
"Licensed physician" means an individual permitted to practice as a
physician under the laws of the state, or a medical officer, similarly
qualified, of the government of the United States while in this state in
performance of his or her official duties.
(5)
"Mentally ill person" ((shall)) means any person who,
pursuant to the definitions contained in RCW 71.05.020, as a result of a mental
disorder presents a likelihood of serious harm to others or himself or
herself or is gravely disabled.
(6)
"Patient" ((shall)) means a person under observation,
care, or treatment in a state hospital, or a person found mentally ill
by the court, and not discharged from a state hospital, or other facility, to
which such person had been ordered hospitalized.
(("Licensed
physician" shall mean an individual permitted to practice as a physician
under the laws of the state, or a medical officer, similarly qualified, of the
government of the United States while in this state in performance of his
official duties.))
(7)
"Resident" means a resident of the state of Washington.
(8)
"Secretary" means the secretary of social and health services.
(9)
"State hospital" ((shall)) means any hospital,
including a child study and treatment center, operated and maintained by
the state of Washington for the care of the mentally ill.
(10)
"Superintendent" ((shall)) means the superintendent of
a state hospital.
(("Court"
shall mean the superior court of the state of Washington.
"Resident"
shall mean a resident of the state of Washington.))
(11)
"Violence" or "violent act" means any physical assault or
attempted physical assault against an employee or patient of a state hospital.
Wherever
used in this chapter, the masculine shall include the feminine and the singular
shall include the plural.
NEW
SECTION. Sec. 3. (1)
By November 1, 2000, each state hospital shall develop a plan, for
implementation by January 1, 2001, to reasonably prevent and protect employees
from violence at the state hospital. The plan shall be developed with input
from the state hospital's safety committee, which includes representation from
management, unions, nursing, psychiatry, and key function staff as
appropriate. The plan shall address security considerations related to the
following items, as appropriate to the particular state hospital, based upon
the hazards identified in the assessment required under subsection (2) of this
section:
(a)
The physical attributes of the state hospital including access control, egress
control, door locks, lighting, and alarm systems;
(b)
Staffing, including security staffing;
(c)
Personnel policies;
(d)
First aid and emergency procedures;
(e)
Reporting violent acts, taking appropriate action in response to violent acts,
and follow-up procedures after violent acts;
(f)
Development of criteria for determining and reporting verbal threats;
(g)
Employee education and training; and
(h)
Clinical and patient policies and procedures including those related to
smoking; activity, leisure, and therapeutic programs; communication between
shifts; and restraint and seclusion.
(2)
Before the development of the plan required under subsection (1) of this
section, each state hospital shall conduct a security and safety assessment to
identify existing or potential hazards for violence and determine the
appropriate preventive action to be taken. The assessment shall include, but
is not limited to analysis of data on violence and worker's compensation claims
during at least the preceding year, input from staff and patients such as
surveys, and information relevant to subsection (1)(a) through (h) of this
section.
(3)
In developing the plan required by subsection (1) of this section, the state
hospital may consider any guidelines on violence in the workplace or in the
state hospital issued by the department of health, the department of social and
health services, the department of labor and industries, the federal
occupational safety and health administration, medicare, and state hospital
accrediting organizations.
(4)
The plan must be evaluated, reviewed, and amended as necessary, at least
annually.
NEW
SECTION. Sec. 4. By
July 1, 2001, and at least annually thereafter, as set forth in the plan
developed under section 3 of this act, each state hospital shall provide
violence prevention training to all its affected employees as determined by the
plan. Initial training shall occur prior to assignment to a patient unit, and
in addition to his or her ongoing training as determined by the plan. The
training may vary by the plan and may include, but is not limited to, classes,
videotapes, brochures, verbal training, or other verbal or written training
that is determined to be appropriate under the plan. The training shall
address the following topics, as appropriate to the particular setting and to
the duties and responsibilities of the particular employee being trained, based
upon the hazards identified in the assessment required under section 3 of this
act:
(1)
General safety procedures;
(2)
Personal safety procedures and equipment;
(3)
The violence escalation cycle;
(4)
Violence-predicting factors;
(5)
Obtaining patient history for patients with violent behavior or a history of
violent acts;
(6)
Verbal and physical techniques to de-escalate and minimize violent behavior;
(7)
Strategies to avoid physical harm;
(8)
Restraining techniques;
(9)
Documenting and reporting incidents;
(10)
The process whereby employees affected by a violent act may debrief;
(11)
Any resources available to employees for coping with violence;
(12)
The state hospital's workplace violence prevention plan;
(13)
Use of the intershift reporting process to communicate between shifts regarding
patients who are agitated; and
(14)
Use of the multidisciplinary treatment process or other methods for clinicians to
communicate with staff regarding patient treatment plans and how they can
collaborate to prevent violence.
NEW
SECTION. Sec. 5.
Beginning no later than July 1, 2000, each state hospital shall keep a record
of any violent act against an employee or a patient occurring at the state
hospital. Each record shall be kept for at least five years following the act
reported during which time it shall be available for inspection by the
department of labor and industries upon request. At a minimum, the record
shall include:
(1)
Necessary information for the state hospital to comply with the requirements of
chapter 49.17 RCW related to employees that may include:
(a)
A full description of the violent act;
(b)
When the violent act occurred;
(c)
Where the violent act occurred;
(d)
To whom the violent act occurred;
(e)
Who perpetrated the violent act;
(f)
The nature of the injury;
(g)
Weapons used;
(h)
Number of witnesses; and
(i)
Action taken by the state hospital in response to the violence; and
(2)
Necessary information for the state hospital to comply with current and future
expectations of the joint commission on hospital accreditation related to
violence perpetrated upon patients which may include:
(a)
The nature of the violent act;
(b)
When the violent act occurred;
(c)
To whom it occurred; and
(d)
The nature and severity of any injury.
NEW
SECTION. Sec. 6.
Failure of a state hospital to comply with this chapter shall subject the
hospital to citation under chapter 49.17 RCW.
NEW
SECTION. Sec. 7. A
state hospital needing assistance to comply with sections 3 through 5 of this
act may contact the department of labor and industries for assistance. The
state departments of labor and industries, social and health services, and
health shall collaborate with representatives of state hospitals to develop
technical assistance and training seminars on plan development and
implementation, and shall coordinate their assistance to state hospitals.
NEW
SECTION. Sec. 8. The
department shall provide an interim report on the progress of the plan
development to the legislature by July 1, 2000, and a copy of the completed
plan by November 1, 2000. The department shall thereafter provide an annual
report to the legislature on its efforts to reduce violence in the state
hospitals not later than September 1st of each year.
NEW SECTION. Sec. 9. Sections
3 through 8 of this act are each added to chapter 72.23 RCW.
