DS Violence and Aggression

Module A – Induction and Awareness Raising

Introduction

• Course objectives
• Legislation
• Na*onal Guidelines
• Health and Safety Executive
• Violence and Aggression, Risk Assessment Defined

Types of Violence & Aggression

• Physical Violence
• Psychological/Emotional Violence
• Sexual Violence
• Economic/Financial Violence
• Cultural Violence
• Institutional/Structural Violence
• Cyber Violence
• Aggressive Behaviour

Combatting Violence and Aggression in the Workplace

• Launch of the NHS Wales Shared Services Programme (video)
• Employer Responsibilities
• Lived Experience (video)
• Employee Responsibilities

Reporting Incidents

• Employee Safety
• Prevention and Risk Management
• Legal Compliance
• Support and Recovery
• Accountability
• Staff Morale & Trust

Established Processes for reporting Workplace Violence and Aggression

• Immediate Action and Safety
• Incident Reporting
• Investigation of the Incident
• Involvement of External Authorities (if necessary)
• Support for Affected Staff

Violence and Aggression in Hospitals

• Lived Experiences (Leeds Teaching Hospital NHS Trust)
• Statistics for 2022/23

Local Policy and Procedures

• Staff Intranet
• Occupational Health or Human Resources (HR) Departments
• Safety and Security Office
• Employee Handbook or Induction Materials
• Health and Safety Department
• Ward or Departmental Noticeboards
• Line Managers or Supervisors

Staff Support Mechanisms

• Occupational Health Services
• Employee Assistance Programmes (EAP)
• Counselling and Psychological Services
• Peer Support Programmes
• Debriefing and Incident Support
• Trauma Informed Care Teams
• Support from Line Managers and Supervisors
• Trade Unions and Professional Bodies
• Health and Safety Department
• Human Resources (HR) Support

Module B – Theory of Personal Safety and De-escalation (Slide 164)

Recap

• Definition of Violence and Aggression

Influencing Factors

• Workplace Layout
• Staffing Levels
• Patient Condition
• Training and Preparedness
• Workplace Policies
• Shift Patterns
• Environmental Stressors

Patient-Related Factors

• Mental Health Issues
• Pain or Discomfort
• Fear or Anxiety
• Frustration with Treatment Delays

Staff-Related Factors

• Overwork and Burnout
• Inadequate Training
• Perceived Disrespect or Miscommunication

Environmental Factors

• Overcrowding and Long Wait Times
• Physical Discomfort
• Lack of Privacy

Family & Visitor Factors

• Emotional Stress
• Unrealistic Expectations

Communication Barriers

• Language Differences
• Lack of Information

Substance Abuse

• Intoxication

Cultural & Personal Belief

• Conflicts Over Care Plans
• Personal Experiences Security & Safety Concerns

• Lack of Security Presence
• Access to Weapons or Dangerous Items

Communication Skills

• Active Listening
• Empathy and Validation
• Calm Tone and Body Language
• Clear and Simple Communication
• Set Boundaries Respectfully
• Stay Non-Defensive
• Offer Assistance
• Use Non-Confrontational Language
• Give Space
• Offer Reassurance
• Know When to Exit or Seek Help

Understanding Organisa*onal Policies and Procedures

• Zero Tolerance Policy
• Risk Assessment and Prevention
• Staff Training & Education
• Reporting & Documentation Procedures
• Use of Restraints
• Support for Staff
• Legal Frameworks and Compliance
• Involvement of Law Enforcement
• Managing Repeat Offenders
• Communication with Patients and Families

Reporting Incidents

• Overview
• Immediate Action Following the Incident
• Incident Report
• Investigation and Follow-Up
• External Reporting
• Supporting Staff Post-Incident
• Staff Support Systems

Module C – Breakaway (slide 339)

De-escalation Techniques & Skills

• Prevention and Preparation
• Ensure Safety
• Self-awareness
• Effective Communication
• Empathy & Validation
• De-escalation Techniques
• Problem-solving and Resolution

Risk Assessment

• Awareness of the Environment and Risk Factors
• Identify Risk Factors
• Environmental Design and Layout
• Communication and Interaction
• Training and Education
• Monitoring and Surveillance
• Support Systems
• Engagement with Patients & Families

Awareness of Personal Safety

• Physical Environment
• Restricted Access Areas
• Personal Health & Wellbeing
• Behavioural Factors
• Interactions with Others
• Medical Equipment
• Challenge Unauthorised Access
• Security Officers & Risk Assessments
• IUDA Loop Decision Making Model
• Corrosive Substances or ‘Acid Attacks’
• Remove, Remove, Remove Protocol
• Personal Protective Measures
• Patient-Related Factors
• Workplace Influencing Factors
• Socioeconomic Conditions

Communication Skills Recap

• Effective Communication
• Active Listening
• Soft, Calm and Steady Tone
• Non-Threatening Body Language
• Empathy
• Validation
• Simple, Clear Language
• Offering Choices

Local Reporting Policies and Procedures

• Knowing when to Report
• Who to Report To
• How to Report
• Confidentiality & Follow-Up
• Compliance with Legal and Organisational Requirements

Employer & Employee Responsibilities

• Recap of Employer & Employee’s Responsibilities
• Key Legal and Ethical Issues
• Use of Force
• Ethical Considerations
• Types of Force
• Justification of Use of Force
• Consequences of Misuse

Gender & Cultural Issues

• Recap

Circumstances When Additional Assistance May Be Required

• Mental health Crisis
• Lack of Staff or Resources
• Vulnerable or High-Risk Individuals
• Cultural or Language Barriers
• Legal or Ethical Concerns

Talk Down Tips

• What is De-escalation
• De-escalation Strategies
• Safewards
• Soft Words
• Calm Down Methods
• Talk Down

Breakaway Techniques

• Non-Restrictive and Restrictive Physical Interventions
• Safety Commands
• GSA Approved Interventions