OSHA Inspection: KIDSPEACE CORPORATION AND KIDSPEACE CHILDREN'S HOSPITAL INC

Issued

2018-10-03 00:00:00

Abate by

2019-04-18 00:00:00

Penalty

Initial $12934.00 · Current $9423.00 Reduced

General-duty citation text

OSH ACT of 1970 Section (5)(a)(1): The employer did not furnish employment and a place of employment which was free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that employees are exposed to the hazard of workplace violence:      a) Facility Wide: On or about April 4, 2018, employees providing inpatient care to clients were exposed to the hazard of workplace violence including but not limited to physical assaults such as biting, kicking, punching, and scratching that resulted in serious physical injuries such as but not limited to lacerations, contusions, sprains, strains, headaches, and concussions.     Among other methods, feasible and acceptable means to abate the hazard of workplace violence include:    Develop and implement a comprehensive workplace violence prevention program which should include:     a. Develop a written workplace violence prevention program that is specific to the conditions and hazards at KidsPeace. The written program should include the following:          i. Designation of the person or team within the facility that is responsible for the location?s workplace violence prevention program.            ii. Clear written description on how to report intimidation and verbal abuse as well as guidelines on when to call police.          iii. Clear written statement about employees seeking prompt medical attention.              iv. Clear written statement that employees will not experience retaliation for seeking medical attention during a shift, reporting incidents of threats or violence, or for calling police.                 v. Information of how and where employees can seek emotional support and mental health care including after hours.     b. Development of workplace violence controls, including implementation of engineering and administrative controls and methods used to prevent potential workplace violence incidents.          i. Develop a committee of at least 50% front line employees to evaluate and determine the appropriate number of staff needed in each unit based on acuity to ensure a safe workplace for employees. Ensure staffing levels are adequate to provide assistance during behavioral emergencies and other calls for assistance as well as for clients on protocols or special precautions. Ensure the staffing levels are met daily and on each shift. Ensure that all staff on each shift are informed of who is it designated to respond to calls for additional staff.             ii. Provide all employees with a reliable and readily available means of communication that are effective throughout the facility. Evaluate all means of communication available such as portable panic alarms/buttons. Evaluate the effectiveness of multiple channels with the current radios in use. Develop a policy to maintain the effectiveness of the communication devices. Inform all employees of this policy. Enforce the policy as necessary.            iii. Perform a workplace hazard assessment of the units to ensure nurse?s stations are secure. Evaluate the height of the nurse?s station desk as well as the depth to prevent patients from jumping over the desk. Ensure that the nurse?s station doors cannot be unlocked by clients. Remind staff how to appropriately access the nurse?s station as to ensure that clients are not shown the deficiencies of the nurse?s stations. Ensure all items on the nurse?s station desk and in other areas are secured or removed so that they cannot be used as weapons.             iv. Evaluate the Protective Sleeves Use and Care standard operating protocol to ensure all staff know how to access and maintain the protective sleeves. Ensure a sufficient number of pairs of protective sleeves are available so that all staff has access to them when needed.             v. Evaluate the need and effectiveness of a response team where employees who are highly proficient in de-escalation and Safe Crisis Management techniques respond to calls for additional staff. Ensure the staffing is adequate so that these team members can respond to calls for additional staff. Provide additional training to refine de-escalation and Safe Crisis Management techniques as necessary.            vi. Ensure employees are trained in safety protocols when transporting clients and the safety protocols are used.            vii. Ensure employees utilize a buddy system while providing service to patients with a history of violence.           viii. Encourage employees to promptly report all incidents regardless of severity or injury occurrence.             ix. Work with local law enforcement to garner their support for staff who call for assistance and decide to press charges against assaultive clients.                 c. Develop a recordkeeping system designed to report any violent incident regardless of severity.  The reports must be in writing and maintained for review after each incident and at least annually to analyze incident trends. Ensure that employees are informed of when and how to report incidents of workplace violence.          i. Investigate all workplace violence incidents as soon as possible to identify root cause and to identify and implement control measures to prevent or minimize the impact of future incidents. Employees involved in the incidents should be included in the investigation. Ensure the findings of an investigation are communicated back to the staff involved in the incident.            ii. Ensure that management at the facility has access to all systems where employees report violent incidents and injuries.            iii. Ensure that debriefing meetings are occurring after all crisis interventions and that staff are involved to determine root cause, what actions worked correctly and any necessary improvements. Ensure the outcome of the debriefing is communicated back to the staff involved in the incident.            iv. Track and trend all workplace violence incidents to identify common risk factors or opportunities for prevention. Risk factors tracked could include location of incident, type of injury, cause of injury, restraints used, personal protective equipment use, clients involved and staffing levels.    d. Ensure employees are trained on the employer's workplace violence prevention program, the employer?s policies and requirements for recording and documenting a patient?s aggressive or assaultive behavior, how and when to complete an Employee Accident Report employee accident investigations, and debriefing procedures.    e. Develop a safety committee for the facility. Involve frontline employees including psychiatrists, social workers, nurses, and mental health technicians. Review all workplace violence incidents and trends during the meetings to ensure effective and timely follow-up. The committee activity and findings should be communicated to all direct care staff. Develop a system for employees to report safety concerns and suggestions anonymously. Develop a system to provide communication and feedback to employees about their safety concerns and suggestions.       f. Annual review of the workplace violence prevention program and updated as necessary. The effectiveness of the program should be evaluated by tracking objective measures of the hazards such as rates of injuries, threats and near misses, as well as the implementation and impact of hazard control measures. Solicit and include employee input in the review.

Issued

2018-10-03 00:00:00

Abate by

2018-10-24 00:00:00

Penalty

Initial $1571.00 · Current $1571.00

General-duty citation text

29 CFR 1904.29(a): The employer did not use an OSHA 300, 301 and 300A Form or equivalent.  a) Facility wide: On or about April 4, 2018, the employer did not enter correctly the location where the injury occurred for injuries on the 2018 OSHA 300 log.  Abatement certification and documentation required within 10 days after abatement date. The certification shall include a statement that abatement is complete, the date and method of abatement, and state that employees and their representatives were informed of this abatement. Abatement documentation shall include documents demonstrating that abatement is complete, such as evidence of the purchase or repair of equipment, photograph or video evidence of abatement or other written records.