Managing the Risk of Workplace Violence to Healthcare and Community Service Providers
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Appendix 4: Workplace Violence - Risk Assessment Form and Samples
Example 2: Maternity Services
Section 1: Context Appendix 4: — setting the scene
| Location: Labour ward | Division:Maternity Services |
|---|---|
| Area/Activity/Person: Mr A Husband (also known under the alias Mr B Husband) previous partner of Mrs Patient (hospital number 03271) has threatened to ‘snatch’ her newborn child. Mr A Husband has previously assaulted Mrs Patient causing her to ‘flee’ to her parents’ home accompanied by her other two children. Mr A Husband currently has a court injunction served on him ordering that he does not come within 200m of Mrs Patient. Mr A Husband is currently using Mrs Patient’s name to secure accommodation in a nearby area. | |
Section 2: Identifying Hazards — what can go wrong and who will be affected
| Hazard | Something with the potential to cause harm | Persons at risk [√] |
|---|---|---|
| A | Mr A Husband accessing Mrs Patient while she is in labour | S [ ] V [ ] P [√] O [ ] |
| B | Mr A Husband entering the Labour Ward and attempting to take the newborn baby by violence means | S [√] V [√] P [√] O [ ] |
S = staff; V = Visitor, P = Patient; O = Other
Section 3: Existing Control Measures —what practical steps are already in place
| Hazard | Existing Control Measures |
|---|---|
| A | Planned admission to labour ward to avoid delivery at Mrs Patient’s home |
| A and B | Security cameras and locked doors throughout the labour ward |
Section 4: Evaluating risk — not ‘worse case scenario’; takes into account existing controls
| Hazard | Consequence ( 1 – 5 ) | X | Likelihood (1 – 5 ) | = | Risk Rating (1 – 25 ) |
|---|---|---|---|---|---|
| A | 4 | X | 3 | = | 12 |
| B | 3 | X | 3 | = | 9 |
Section 5: Risk prioritised action plan - applying the hierarchy of controls:
E=eliminate I=isolate M=minimise
| Hazard | E /I/ M | Practicable Steps required to further control risk | Responsibility |
|---|---|---|---|
| A and B | M | Make copies of photo provided by Mrs Patient to ensure the labour ward staff, including receptionist, can readily identify Mr A Husband. | Ward manager |
| A and B | I | Liaise with hospital security personnel to review current security measures including changing the key codes on the locks accessing the labour ward. | Hospital security. |
| A | M | Video surveillance is in operation, however, the tapes are currently erased after a 48-hr period. Purchase additional tapes to increase capacity and retain data for a seven-day period in support of possible legal action against Mr A Husband. | Reception. |
| A and B | I | On admission to labour ward ensure the central records do not indicate Mrs Patient’s name has been assigned to any beds. Local knowledge is all that is required. | Bed bureau |
| A and B | I | Discuss with the local police station this situation to agree a prioritised callout using either the 111 number or a direct dial to the station. On agreement this is to be conveyed with the receptionist who is authorised to call for police assistance and the subsequent removal of Mr Husband when in the proximity of the reception. | All labour ward staff. |
| A and B | I | NO information pertaining to Mrs Patient is to be given over the phone. This includes confirmation that Mrs Patient is even on the ward. Only Mr Patient’s parents may have access to the ward. | All labour ward staff |
| B | M | Instigate early liaison with other agencies to plan for the safe transfer and continued support of Mrs Patient and child on discharge to her home; Child Protection, Community Services etc. | Community liaison team |
Section 6: Further Information: cross-sector safety responsibilities
| Who is responsible for local monitoring?: Ward manager |
| Is further competent (clinical risk, manual handling) advice required? Yes / No Comments: Hospital Security, Local Police |
| Do third parties (agencies) require a copy of this risk assessment for their safety? Yes / No Comments: Hospital Security, Local Police |
Section 7: Assessment Sign-Off – assessment monitoring responsibilities
| Assessor’s name: Risk assessor |
| Date of assessment: 23 August 2005 |
| Assessor’s signature: |
| Review: (tick one) daily weekly monthly yearly |
| Reassessment date: on discharge |
| Manager’s signature: |