Snap judgementOn 1 Jul 2001 in Personnel Today A simple risk assessment which can bedone by anybody in just two minutes is a useful tool to help prevent violencein the workplace, by Walter BrennanViolence in the workplace continuesto be a major problem for organisations.Left unaddressed, violence damages people and morale, increasessickness rates, tarnishes the organisation’s commercial profile and costsmillions of pounds in terms of replacement costs or increasing litigation underhealth and safety legislation.The 1992 Management of Health and Safety at Work Regulationshighlight the need for employers to identify hazards in the workplace andassess the risk1.Violence was classified as a hazard under the Reporting ofInjuries, Dangerous Disease Occurrence Regulations (Riddor 1995)2, which cameinto effect on 1 April 1996. This is significant because it finally identifiedviolence as a notifiable hazard.For many years mental health professionals have endeavoured topredict the likelihood of a person being violent. Clinicians tend to beascribed the “expertise” necessary to make such predictions, but thishas yet to be tested and demonstrated empirically. Monahan (1981) indicatedthat professionals who aim to predictthe likelihood of violence only have a success rate of 40 per cent3. There have been some impressive risk assessment models based ona combination of actuarial and clinical issues. The problem, however, is thatmany of these improved tools are either extremely time-consuming or technicalor both.Furthermore, many of the existing health and safety riskassessment tools available are either designed specifically for inanimate typesof hazard, for example spillages, or manual handling.Despite the legal requirement to carry out risk assessment, a numberof surveys conducted over the past 12 months reveal some startling, but notsurprising facts: staff working with potentially and actually violent peoplewere not carrying out risk assessment in relation to violence4.A survey showed that:– 60 per cent of social workers (n=55),– 45 per cent of accident and emergency nurses (n=71),– 72 per cent of retail workers (n=31), and– 89 per cent of personnel staff (n=19)had absolutely nothing in place in terms of risk assessment forviolence.This led to an attempt to devise a risk assessment device thatcould be used in a number of environments by different staff.PlanningBecause different people may express different behaviours indifferent situations, it was felt important to explore the link between theperson and the situation.The assessment had to have the following features:– Be easy to use– Be free from jargon– Be quick– Not need a clinical background– Be easy to access– Be simple to score– Fit on one page of A4 – Aim to combine clinical with health and safety issuesUse of the toolThis risk assessment questionnaire has been adopted by threehospitals, two schools, one local authority and is at present being piloted bya hospital in London and two retailers in Nottingham.ConclusionThis simple risk assessment tool is intended to be used by avariety of disciplines at first point of contact with clients, members of thepublic and even employees.A more comprehensive assessment can follow on from thistwo-minute exercise going into more detail about the person and exploring wideraspects of the human condition.Walter Brennan is a freelancetraining consultant, who has worked with the Department of Health on its ZeroTolerance campaignReferences1. Health and Safety Commission (1992) Management of Health andSafety at Work: Approved code of practice. Management of Health and SafetyRegulations. London: HMSO.2. Health & Safety Executive (1996) A Guide to theReporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995.London: HMSO.3. Monahan J (1981) The Clinical Prediction of ViolentBehaviour, 627-628. Washington DC: Government Printing Office, and RockvilleMD: NIMH4. Brennan W (1999) Risk Assessment, Violence and Dangerousnessin the Workplace: Nursing and Residential Care, 1 (3): 159-163.Brennan’s two-minute risk assessment of violence1: Do you know the person? Yes = 5 No = 10 The best predictor of future behaviour is past behaviour. 2: If yes, does the person have a known history of violence? Yes =10 No = 0 Don’t know = 10 If a person has a known history of violence, then this must be acknowledged.Of course a person may have been violent as a result of a set of unique andexceptional circumstances and these circumstances may never re-occur. Nevertheless,if known, a history of violence needs to be acknowledged. What is of moresignificance is the score attached to the “don’t know” response. Ifwe are not aware of any history of violence, we may assume the person not to beviolent. This is not good practice. Until you have evidence that the person isnot violent, then the default should always be, “If you are not sure,assume the worse”. 3: Has the person become verbally abusive or suddenly become quiet? Yes = 10 No = 0 If there is a noticeable change in someone’s behaviour, this should causealarm, as such changes are indicative of unpredictable behaviour.Unpredictability should prompt caution. Verbal abuse is often a precursor tophysical violence. 4: Has the person said he/she intends to become violent towards you or acolleague? Yes = 10 No = 0 As obvious as it seems, many employees who deal with threats of violence ona daily basis can become “immune” to the incident whereby the person,after threatening violence, then executes it, prompting “surprise”from the victims or statements such as, “I didn’t think he/she wouldattack me”. 5: Does the person have or appear to have a mental health problem? Yes = 10 No = 0 Mental health problems are often erroneously associated with violence. However,research suggests that a person who is unknown and who may be expressingbizarre behaviours or responding to hallucinations may be unpredictable and asource of anxiety. 6: Is the person under or appear to be under the influence of drugs oralcohol? Yes = 10 No = 0 There have been numerous pieces of research aimed at exploring the linksbetween alcohol and drugs and violence. One of the most common reactions toalcohol and drugs is disinhibition. 7: Is the person’s body language hostile or aggressive? Yes = 10 No = 0 8: Is the task being undertaken likely to cause the person to becomeangry, for example, are you giving bad news? Are you doing something the personmay find painful or distressing? Yes = 10 No = 0 One of the most common triggers of violence in the workplace is the use ofwords such as “No”, in other words – not giving someone what he orshe wants. This is a situational factor that needs to be taken intoconsideration. 9: Are there the correct number of staff on duty and available to managea violent situation should it arise? Yes = 5 No = 10 The idea of this risk assessment is to balance the risk of violence againstthe safe systems of work in place, which can minimise or even eliminate therisk of violence. Note that the correct number of staff might be two or three. This number maybe more effective in dealing with a situation than say, five or six staff. 10: Does your unit provide safety first for staff? CCTV = 9 personal alarm system = 9 Training in aggression management = 5 No = 10 It is important to understand that having no safety systems in placeattracts a score of 10. Personal alarm system or close circuit TV are only 1point less each. Training in aggression management scores 5. 11: Do staff feel comfortable about the situation? Yes = 5 No = 10 This is about intuition or “gut feelings”. Although somewhatunscientific, many victims of violence have in retrospect articulated viewsthat something was not right. Intuition does have a role and should not bedismissed as crude or primitive. Add up the scores: 13 – 34 = low risk of violence. 35 – 84 = medium to high risk of violence. 85 – 110 = high risk of violence. Previous Article Next Article Comments are closed. Related posts:No related photos.