Enforcement and Inspection

Workplace Violence Hazards Lead to Citation of Psychiatric Treatment Center

A Louisville, Colorado, psychiatric treatment hospital failed to protect employees from workplace violence, OSHA alleged.

Healthcare workplace violence

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The agency charged UHS of Centennial Peaks, LLC, with two serious, two repeat, and two other-than-serious violations. OSHA inspected Centennial Peaks Hospital, an acute psychiatric treatment facility, after receiving a complaint of workplace violence in December 2018. The agency proposed penalties of $32,392.

Cited violations include failing to protect employees from workplace violence and bloodborne pathogens hazards and failing to log a recordable injury.

Workplace Violence Citations

Centennial Peaks Hospital failed to protect its employees from physical threats and assaults from patients, OSHA charged, citing the hospital with a serious violation of the Occupational Safety and Health Act’s general duty clause. There is no federal workplace violence prevention standard. The general duty clause requires employers to provide a workplace free of safety and health hazards.

Employees at the facility, including nurses and mental health counselors, were exposed to hazards such as:

  • Serious injuries due to patient attacks, including bites; bruising; concussions; injuries to the head, legs, and torso; lacerations; scratches; and sprains from forceful grabs, kicks, punches, pushes, and tripping; and
  • Assaults and physical threats during routine procedures involving patients with known histories of violent behavior.

Despite the lack of a workplace violence prevention regulation, the Occupational Safety and Health Review Commission has reaffirmed employers’ responsibility to protect healthcare, social assistance, and other workers from on-the-job violence even violence involving non-employee third parties.

OSHA gave Centennial Peaks Hospital instructions for the abatement of workplace violence hazards. The agency told the hospital to:

  • Develop a written comprehensive workplace violence prevention policy that would assess and evaluate incidents and trends and solicit employee input, analyze hazards, provide clear procedures for responding to threats and assaults, implement administrative and engineering controls, and annually review the policy;
  • Designate dedicated staff to monitor patient behavior and respond to incidents of workplace violence;
  • Ensure items in workstations such as computers and peripherals, cords, hole punchers, staplers, and telephones are not accessible to patients for use as weapons;
  • Implement procedures for post-incident de-briefing and investigation, including investigation and analysis of near misses;
  • Provide communications devices such as personal panic alarms or walkie-talkies to all case workers, housekeeping staff, mental health counselors, and nurses who work in close proximity to patients;
  • Provide workplace violence prevention training in communications, de-escalation and restraint, escape and self-extraction, incident response, post-incident de-briefing and root-cause analysis, and securing badges and communications devices; and
  • Reconfigure nurses’ stations to prevent patients from entering, jumping over, or reaching into work areas.

Bloodborne Pathogens Citations

OSHA also cited Centennial Peaks Hospital for one serious and two repeat violations of the bloodborne pathogens standard.

OSHA cited the hospital with a serious violation for failing to adequately train employees in the use and limitations of devices and methods to prevent exposure to bloodborne pathogens and other potentially infectious materials.

Repeat violations included:

  • Failing to annually review and update the hospital’s exposure control plan and consider adoption of commercially available, safer devices; and
  • Failing to locate sharps disposal containers near sites where lancets, syringes, and other devices are used in patient care.

OSHA charged Centennial Peaks Hospital with other-than-serious violations for:

  • Failing to log a recordable injury when an employee’s injury resulted in work restriction; and
  • Failing to have workers who declined hepatitis B vaccination sign a required statement acknowledging they declined employer-provided vaccination.

Centennial Peaks Hospital has until July 5 to abate the cited hazards or violations. The employer also may request an informal conference with the agency’s area director or contest the citations before the Occupational Safety and Health Review Commission.