About two million Americans are victims of workplace assaults each year.
- One thousand are killed
- 40,000 are victims of aggravated assaults
- 1.5 million are victims of simple assaults
- 51,000 are raped and/or sexually assaulted
- Homicides account for 1 out of 6 fatal occupational injuries
- Firearms were used to commit more than 80% of these workplace homicides
A threat of violence
Includes any behavior that by its very nature could be interpreted
by a reasonable person as intent to cause physical harm to another
An act of violence
Includes any physical action, whether intentional, reckless, or
accidental that harms or threatens the safety of another individual in
Potentially violent and unacceptable behavior includes:
- Exaggerated tone of voice, screaming or yelling
- Throwing objects
- Name calling and use of derogatory statements
- Berating individuals in front of others
- Cursing, cussing and foul language
- Aggressive movement, gestures and actions
Recognize, Respond and Report
Sensitivity to subtle and more apparent aggressive behavior is
key to prevention and early intervention to a situation that could
escalate into a threatening situation.
This includes not making
excuses or overlooking insults, verbal aggression, and other behaviors
that exhibit anger and frustration
People do not go directly to anger; there is a progression
Pay attention to what is said,
“Someone ought to ____________.”
“I could _____________________.”
“I’m gonna __________________!”
Use of the personal pronoun is a good indication that the individual has made a plan to carry out the threat.
Response can include reducing or eliminating a source of irritation and using techniques to de-escalate the situation.
Recognizing and Responding to Behavior
Anxiety - initial phase of agitation, behaviors may include
restlessness, pacing, inability to focus, frustration,
Your Response-empathetic and active listening; no judgment,
dismissing or mitigating the individual’s feelings or perceptions. It
is important to validate the person’s feelings.
Defensive -highly volatile state exhibiting verbal belligerence
and hostility; challenging authority, unable to respond to rational
content of words; responds instead to tone, personal space and body
language. Verbal aggression may include ethnic slurs and
disrespectful or belittling comments.
Your Response - set clear, simple, reasonable and easy to
enforce limits in an objective manner without being threatening;
convey that the individual has a choice. It is important to not lose a
professional hold of the situation.
Tension Reduction - physical and emotion release; behaviors
include apologetic, emotionally withdrawn, fear, confusion,
Your Response - therapeutic rapport or communication is usually
well received. Re-assure the individual that no one will harm them.
Allow time for the individual to calm down before transporting.
Explain what will happen next, allow the individual to make choices;
form a verbal contract.
Acting out - behaviors include total loss of control; verbal
aggression may turn to physical aggression, physical assault may be
directed toward others, self or environment
Your Response - physical intervention should only be used as a
last resort and never punitively. Non-injurious restraint techniques
Employees should report any behavior which is threatening or violent, for example: exaggerated tone of voice, screaming or yelling throwing objects name calling and use of derogatory statements berating individuals in the presence of others use of expletives and foul language aggressive movement, gestures, actions.
- Call UTMB Police at extension 2-1111.
- Describe location and events. Give your name.
- Give a complete subject description for responding officers.
- Notify immediate supervisor or department head
- Use the Patient Event Reporting System (Juvo) to report all acts or threats of violent behavior.
How to Use the Patient Event Reporting System (Juvo) to report acts of violence
An act of violence is an act of violence - It does not matter who “hit first”
Report threats, acts and potential violent and unacceptable behavior:
- Click on the Patient Event Reporting System (Juvo) link via the iUTMB Home Page.
- Populate all fields as you would for any other Patient Safety concern:
- Select the event facility.
- Select either a non-patient or a patient with a known encounter as the person harmed.
- Launch and complete the Behavioral Event form.
Using the Patient Event Reporting System (Juvo) will allow UTMB to track trends and better understand areas of vulnerability.