78 156 Definition Any violent act including physical assault and threat of assault directed toward persons at work or on duty. This can include threats, harassment, bullying, stalking, intimidation, verbal abuse, physical assault, terrorism, and homicide. Characteristics Many violent incidents are preceded by warning signs from the assailant, including belliger- ent behavior, use of harassing or abusive language, verbal threats to do physical harm, known substance abuse, angry threats of suicide, revealing a weapon, remarks about access to a weapon, or obsessive romantic attraction. Industries and occupations at greatest risk for workplace violence are those that involve the exchange of money, late-night or early-morning work hours, working alone or in small num- bers, working in high-crime areas, work involving guarding valuable property or possessions, and work in community settings. Such types of high-risk workplaces and occupations might suggest that robbery is the predominant motive, but some homicides are caused by disgrun- tled workers or clients or by domestic violence that spills over into the workplace. Policy Evaluate for injury and further counseling in the occupational health unit any employee who presents with or without physical injury or with psychological distress due to an incident of workplace violence. Transport employee with life-threatening injuries to the hospital for treatment. If a violent incident is still in progress, contact security or 911. (Develop a work- place violence prevention program that follows Occupational Safety and Health Administra- tion’s (OSHA) guidelines refer to Violence Prevention guideline, page 302.) Objectives Clinical Assessments and Interventions Referral for Medical Action Violence in the Workplace ● Serious injury. ● Psychological trauma. ● Persistent stress related to the incident. Follow-up Actions ● Assist qualified personnel (such as the EAP counselor) to perform critical incident debriefing with work group. ● Provide employee with informa- tion regarding workplace vio- lence, risk factors, warning signs, and reporting mechanism for actual or potential workplace violence. Determine extent and severity of physical injury and violent episode. Determine emotional stress and trauma. Document incident. ● Obtain brief history of violent incident. ● Assess nature and degree of any resultant injury and apply appropriate intervention (refer to appropriate guideline). ● Check and record vital signs initially and as frequently as needed. ● Assess psychological impact on employees involved in the incident. ● Assess bystanders, visitors, or others who witnessed the incident and might suffer from psychological impact. ● Include EAP counselor in the assessment, management, and referral of employees (with employee permission). ● Record injury or incident in employee health record and, if appropriate, record in the OSHA log. Guideline continues on next page