OSHA Inspection: UHS OF WESTWOOD PEMBROKE

Issued

Apr 7, 2017

Abate by

Jun 26, 2023

Penalty

Initial $12,675 · Current $25,350

General-duty citation text

OSH ACT of 1970 Section (5)(a)(1):   The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that employees are exposed to assaults by patients.    Employees including Nurses, Mental Health Associates (MHAs), and Crisis Intervention Specialists (CISs) at UHS of Westwood Pembroke, Inc. (Pembroke Hospital) have suffered serious workplace violence related injuries such as concussion, fracture, strains, contusions, and burns (from hot coffee thrown at face) while performing their job duties, such as attempting to prevent injuries to staff and patients, and during restraint holds.    Engineering and Work Practice Controls:     1)      Extend security camera coverage for all common areas. Ensure that security cameras are continuously monitored by trained security or in house monitoring staff for all units. Ensure staff and patients are informed of the camera surveillance.     2)      Install a barrier between the front seats and rear seats of company vehicles used to transport patients to prevent patients from being able to reach over the front seats and assault drivers.     3)      Install 'unbreakable' convex mirrors in hallways with blind spots.     4)      Improve emergency communication -    Supplement the existing two-way radios with personal panic alarms for every employee working on the unit, including, but not limited to, Nurses, MHAs, Housekeeping staff, and Case Workers, who may be in close proximity to an agitated/escalating patient, in order to rapidly and reliably summons assistance to eliminate or minimize employee injury from workplace violence. Provide training on this equipment.    5)      Evaluate and reconfigure the open design Mental Health Associate (MHA) workstations to ensure patients cannot reach into the work area and assault or injure employees. Additionally, secure all items that might otherwise be accessible to a patient during a violent episode, including phones, computers, equipment, and other items that can be thrown.    6)      Encourage staff to secure loose hair so that it is not accessible to patients, to minimize the risk of neck strains and hair pull injuries.    7)      Have security staff available to assist in responding to violent events on all three shifts and to monitor units.       Training:    8)      Ensure that all staff members that may come into contact with patients in the course of their work are regularly trained in methods to protect themselves in situations where patients become violent.     Administrative Controls:    9)      Use a metal detector wand to search visitors and identify potential weapons prior to a patient visit.       Post Incident:    10)  Immediately re-evaluate any patient who assaults another individual to determine what specific measures may be necessary to protect the staff (such as change in treatment plan, and/or additional or more frequent monitoring of the patient).      11)   Conduct effective investigations and root cause analysis of workplace violence incidents. Such investigations and analysis should include:        - Regular evaluation and response to Staff Restraint Debriefing Forms to ensure prompt and thorough debriefings of all staff involved in the response.  Solicit staff input related to their suggestions for improvements. Staff should be encouraged to make suggestions to improve staff safety.        - Update facility Employee Accident Reports to consistently include documented supervisor input and follow-up with the affected employee.        - Solicit feedback from impacted employees regarding root cause analysis, including but not limited to recommendations for improving core safety program components.