AN
ACT Relating to prevention of workplace violence in health care settings;
adding a new chapter to Title 49 RCW; creating new sections; and prescribing
penalties.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW
SECTION. Sec. 1. The
legislature finds that:
(1)
Violence is an escalating problem in many health care settings in this state
and across the nation;
(2)
Based on an analysis of workers' compensation claims, the department of labor
and industries reports that health care employees face the highest rate of
workplace violence in Washington state;
(3)
The actual incidence of workplace violence in health care settings is likely to
be greater than documented because of failure to report or failure to maintain
records of incidents that are reported;
(4)
Patients, visitors, and health care employees should be assured a reasonably
safe and secure environment in health care settings; and
(5)
Many health care settings have undertaken efforts to assure that patients,
visitors, 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 health care settings.
NEW
SECTION. Sec. 2. For
purposes of this chapter:
(1)
"Health care setting" means:
(a)
Hospitals as defined in RCW 70.41.020;
(b)
Home health, hospice, and home care agencies under chapter 70.127 RCW, subject
to section 8 of this act;
(c)
Evaluation and treatment facilities as defined in RCW 71.05.020(8); and
(d)
Community mental health programs as defined in RCW 71.24.025(8).
(2)
"Department" means the department of labor and industries.
(3)
"Employee" means an employee as defined in RCW 49.17.020.
(4)
"Violence" or "violent act" means any physical assault or
verbal threat of physical assault against an employee of a health care setting.
NEW
SECTION. Sec. 3. (1)
By July 1, 2000, each health care setting shall develop and implement a plan to
reasonably prevent and protect employees from violence at the setting. The
plan shall address security considerations related to the following items, as
appropriate to the particular setting, based upon the hazards identified in the
assessment required under subsection (2) of this section:
(a)
The physical attributes of the health care setting;
(b)
Staffing, including security staffing;
(c)
Personnel policies;
(d)
First aid and emergency procedures;
(e)
The reporting of violent acts; and
(f)
Employee education and training.
(2)
Before the development of the plan required under subsection (1) of this
section, each health care setting 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, a measure of the frequency of, and an identification of
the causes for and consequences of, violent acts at the setting during at least
the preceding five years or for the years records are available for assessments
involving home health, hospice, and home care agencies.
(3)
In developing the plan required by subsection (1) of this section, the health
care setting may consider any guidelines on violence in the workplace or in
health care settings 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 health care
setting accrediting organizations.
NEW
SECTION. Sec. 4. By
July 1, 2001, and on a regular basis thereafter, as set forth in the plan
developed under section 3 of this act, each health care setting shall provide
violence prevention training to all its affected employees as determined by the
plan. The training shall occur within ninety days of the employee's initial
hiring date unless he or she is a temporary employee. For temporary employees,
training would take into account unique circumstances. 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;
(3)
The violence escalation cycle;
(4)
Violence-predicting factors;
(5)
Obtaining patient history from a patient with violent behavior;
(6)
Verbal and physical techniques to de-escalate and minimize violent behavior;
(7)
Strategies to avoid physical harm;
(8)
Restraining techniques;
(9)
Appropriate use of medications as chemical restraints;
(10)
Documenting and reporting incidents;
(11)
The process whereby employees affected by a violent act may debrief;
(12)
Any resources available to employees for coping with violence; and
(13)
The health care setting's workplace violence prevention plan.
NEW
SECTION. Sec. 5.
Beginning no later than July 1, 2000, each health care setting shall keep a
record of any violent act against an employee, a patient, or a visitor
occurring at the setting. At a minimum, the record shall include:
(1)
The health care setting's name and address;
(2)
The date, time, and specific location at the health care setting where the act
occurred;
(3)
The name, job title, department or ward assignment, and staff identification or
social security number of the victim if an employee;
(4)
A description of the person against whom the act was committed as:
(a)
A patient;
(b)
A visitor;
(c)
An employee; or
(d)
Other;
(5)
A description of the person committing the act as:
(a)
A patient;
(b)
A visitor;
(c)
An employee; or
(d)
Other;
(6)
A description of the type of violent act as a:
(a)
Threat of assault with no physical contact;
(b)
Physical assault with contact but no physical injury;
(c)
Physical assault with mild soreness, surface abrasions, scratches, or small
bruises;
(d)
Physical assault with major soreness, cuts, or large bruises;
(e)
Physical assault with severe lacerations, a bone fracture, or a head injury; or
(f)
Physical assault with loss of limb or death;
(7)
An identification of any body part injured;
(8)
A description of any weapon used;
(9)
The number of employees in the vicinity of the act when it occurred; and
(10)
A description of actions taken by employees and the health care setting in
response to the act. 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 upon request.
NEW
SECTION. Sec. 6.
Failure of a health care setting to comply with this chapter shall subject the
setting to citation under chapter 49.17 RCW.
NEW
SECTION. Sec. 7. A
health care setting needing assistance to comply with this chapter may contact
the federal department of labor or the state 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 health
care settings to develop technical assistance and training seminars on plan
development and implementation, and shall coordinate their assistance to health
care settings.
NEW
SECTION. Sec. 8. It is
the intent of the legislature that any violence protection and prevention plan
developed under this chapter be appropriate to the setting in which it is to be
implemented. To that end, the legislature recognizes that not all professional
health care is provided in a facility or other formal setting, such as a
hospital. Many services are provided by home health, hospice, and home care
agencies. The legislature finds that it is inappropriate and impractical for
these agencies to address workplace violence in the same manner as other,
facility-based, health care settings. When enforcing this chapter as to home
health, hospice, and home care agencies, the department shall allow agencies
sufficient flexibility in recognition of the unique circumstances in which
these agencies deliver services.
NEW
SECTION. Sec. 9. (1)
State hospitals, as defined in RCW 72.23.010, shall comply with all the
requirements of sections 1 through 3 and 5 through 8 of this act.
(2)
By July 1, 2001, and on a regular basis 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. Each employee shall receive violence prevention training prior to
providing patient care, 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 topics provided in section 4 of this act,
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.
NEW
SECTION. Sec. 10. If
specific funding for purposes of section 9 of this act, referencing this act by
bill and section number or chapter and section number, is not provided by June
30, 1999, in the omnibus appropriations act, section 9 of this act is null and
void.
NEW
SECTION. Sec. 11.
Sections 2 through 8 of this act constitute a new chapter in Title 49 RCW.
