E: T: +44(0) Work-Related Violence Phil Leather

© Zeal Solutions 2007 Structure/Overview  Brief overview of consequences of work- related aggression and violence  Importance of social support, especially management support  The RCN sponsored risk assessment project  Risk-assessment – risk management for work-related violence  The importance of evidence

© Zeal Solutions 2007 Impact of violence  Stress reactions  Poorer general health  Anxiety  Psychosomatic symptoms  Isolation  Loneliness  Deterioration of relationships  Concentration problems  Impaired problem solving capacity  Reduced self confidence  Absence  Diminished work satisfaction  Fear reactions  Post traumatic stress  Burnout

Impact of violence © Zeal Solutions 2007 MeanJSOCItQPSSCBOCIS Verbal (not at you)5.12 Verbal at you: alcohol / drugs4.15 Verbal at you: predisposing condition 3.31 Verbal at you: no mitigation3.22  Threatening behaviour3.06 Physical assault1.76  Racial abuse1.44  % variance explained

The potency of support © Zeal Solutions 2007

The potency of support © Zeal Solutions 2007 JSOCItQPSSCBOCIS Non management Management % variance explained

 Develop a risk assessment tool for Work- Related Violence (WRV)  Greater support to representatives – conducting high quality risk assessments  Improve consistency, reliability and quality of data gathering and information management  Improve individual and collective capability for dealing with WRV RCN: Risk assessment project

© Zeal Solutions 2007 Your help…  Stress reactions  Poorer general health  Anxiety  Psychosomatic symptoms  Isolation  Loneliness  Deterioration of relationships  Concentration problems  Impaired problem solving capacity  Reduced self confidence  Absence  Diminished work satisfaction  Fear reactions  Post traumatic stress  Burnout

© Zeal Solutions 2007 Example items “I like helping people and sorting out any problems.” “I started out wanting to help people personally but I’ve changed and become harder.” “I have become more cynical to people and more mistrustful.” “I have become impersonal in contacts with customers.” “I don’t smile as much.” “I have become indifferent about what happens to customers.” “It’s a ‘them’ and ‘us’ situation between LU staff and the travelling customers.” “I really enjoy talking to customers.” “I don’t want to talk with people but want to withdraw.”

© Zeal Solutions 2007 Exercise  The key question: How does violence affect the quality of the relationship between a patient and a member of healthcare staff?  Your help: how can we measure, understand better this relationship: Complete the proforma Discuss your responses with the person next to you Can you generate any further ideas together

© Zeal Solutions 2007 Model for RA & RM RISK Hazards RISK FOR VIOLENCE Harm IMPACT ON OUTCOMES Things that make a difference PRIMARY SECONDARY TERITIARY

© Zeal Solutions 2007 Rationale  Interventions to manage WPV require reliable & systematic evidence regarding: Nature of violence experienced Damage caused (health & operational terms) Identification of any moderating or exacerbating factors  Evidence informs nature & design of interventions e.g. training, post-incident response, etc.  Risk assessment offers framework for gathering evidence

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