California OSHA is implementing a new regulation titled Workplace Violence Prevention in Health Care under section 3342.

The regulations take effect on April 1, 2017.

As of April 1, 2018, sections (c) Workplace Violence Prevention Plan, (e) Review of Workplace Violence Prevention Plan, and (f) Training must be in place.

The regulations require health care facilities in California to comply with a variety of standards for violence prevention.

According to the regulations, the term “health facility” includes facilities with the following bed classifications, as established by the California Department of Public Health:
  • General acute care hospital
  • Acute psychiatric hospital
  • Skilled nursing facility
  • Intermediate care facility
  • Intermediate care facility/developmentally disabled – habilitative
  • Special hospital
  • Intermediate care facility/developmentally disabled
  • Intermediate care facility/developmentally disabled – nursing
  • Congregate living health facility
  • Correctional treatment center
  • Nursing facility
  • Intermediate care facility/developmentally disabled – continuous nursing (ICF/DD-CN)
  • Hospice facility
The regulations also apply to:
  • Home health care and home-based hospice
  • Emergency medical services and medical transport
  • Drug treatment programs
  • Outpatient medical services to incarcerated in correctional and detention settings
If your organization is one of these types, you will likely be required to augment your Injury and Illness Prevention Program (IIPP), already required by Section 3203, to include elements related to identifying and responding to workplace violence hazards. Such elements include developing a plan that will encourage employee participation, reporting, responding to, and managing workplace violence hazards.

Need help?

This might seem like a daunting challenge, as in addition to implementing the plan, staff must also be trained in applying the plan with techniques for recognizing and responding to workplace violence incidents.

At the Crisis Prevention Institute, we’re here for you. We assist our clients in implementing workplace violence prevention plans, and when it comes to training, we have you covered.

Here’s what the new regulations require in terms of initial training, and how we can help:
  1. An explanation of the employer’s workplace violence prevention plan. After customizing a training plan for you, CPI can assist in defining and clarifying your policies.
  2. Training and annual retraining of employees whose assignments involve confronting or controlling persons exhibiting aggressive or violent behavior. The training is required to address general and personal safety measures, verbal de-escalation techniques, and aggression and violence-predicting factors. This is the core of Nonviolent Crisis Intervention® training, which teaches staff about the signs of potential violence, how to use verbal de-escalation techniques, and strategies for prevention and intervention.
  3. Strategies to avoid physical harm. We developed the disengagement techniques in our curriculum to help your staff stay out of harm’s way.
  4. Appropriate and inappropriate use of restraining techniques. Crisis Prevention Institute training teaches the risks of restraints, and how to avoid them by preventing the need for restraint in the first place. Nonviolent Crisis Intervention® training emphasizes using physical restraint only as a last resort, and includes a risk assessment tool called the Decision-Making Matrix to help staff choose the least-restrictive intervention in every situation. It also includes safer, less-restrictive physical intervention techniques to be used only as a last resort if a person presents an immediate physical danger to self or others and all nonphysical intervention options have been exhausted. CPI’s last-resort restraint techniques are the most adaptable in the industry. CPI training can be customized to your health care facility’s needs, and it empowers staff with trauma-informed, person-centered skills so that restraint is never used as a means of coercion, discipline, convenience, or retaliation.
  5. Appropriate and inappropriate use of medications as chemical restraints. With customized training, we can help you develop supportive, person-centered approaches to use in the event that chemical restraints need to be used.
  6. Reviewing and evaluating workplace violence incidents that result in a serious injury or fatality. Our debriefing tool, the CPI COPING Model℠, is a great way to get started with reviewing incidents and preventing recurrences. It helps you with reviewing serious injuries and fatalities, as well as with reviewing more common incidents of verbal violence. You can also take debriefing a step further with our additional resources on critical incident reporting, including a free resource, DVD refresher programs, and a Topic Module on debriefing.
  7. Interactive questions and answers with someone who’s knowledgeable about your workplace violence prevention plan. With CPI’s train-the-trainer model, staff who attend the Instructor Certification Program become your in-house experts. By mastering CPI techniques and teaching them to other staff, a Nonviolent Crisis Intervention® trainer becomes a knowledgeable resource for staff who have questions. Question-and-answer sessions are an integral part of all CPI training programs, even those you conduct via online/blended learning. For example, webcams are one of just a few ways to create an interactive session if you’re conducting online training. You can also have in-person discussions during the classroom portion of our blended Nonviolent Crisis Intervention® training. If you choose to conduct training entirely in person, there are even more opportunities for discussion. CPI support is also here for you to help you implement training effectively, problem-solve any issues staff are facing, and find answers to complex questions and situations. 

Annual retraining

The regulations also require refresher training at least annually for employees performing patient-contact activities to review the topics included in their initial training.

To help you with this, CPI has the largest selection of refresher courses to not only refresh your staff in existing content, but to give them new skills as well. Topics ranging from advancing verbal skills to dealing with weapons in the workplace—and much more—can help you refresh and expand staff confidence and competence.

Making it all work for you

With both initial and ongoing training to accomplish, it can seem like a lot. A lot of time. A lot of resources.

To help you meet the requirements while still watching the bottom line, CPI leads the training industry with online learning options. From blended learning (mentioned above) to Video-on-Demand and DVD programs, you have numerous options to choose from. Many are also integrated with topics that are deeply relevant to heath care, such as Trauma-Informed Care.

These options can be made available to employees outside of a traditional classroom setting, to view on their own, attend as a group, or attend online—to save you time, money, and resources while equipping staff with comprehensive skills.

What else can CPI support you in implementing?

  • General and personal safety measures. Nonviolent Crisis Intervention® core content equips staff with general and personal safety techniques.
  • Aggression and violence-predicting factors. The same content teaches staff about the signs of aggression, how to handle them, and how to read a situation for indicators of violence.
  • Understanding the assault cycle. In CPI training, the Crisis Development Model℠ describes recognizable behavior levels that an escalating person might go through during a crisis. It also describes corresponding staff attitudes and approaches to de-escalate challenging behaviors.
  • Characteristics of aggressive and violent patients and victims. CPI’s trauma-informed, person-centered training will help you with what to look for and how to assess.
  • Verbal and physical maneuvers to defuse and prevent violent behavior. Prevention is what CPI training is all about. It’s the focus. It’s our middle name. We also teach verbal de-escalation and physical disengagement skills to defuse any incidents that staff can’t successfully prevent.
  • Strategies to prevent physical harm. CPI training involves personal disengagement skills to keep staff physically safe from strikes, grabs, and other injuries and assaults—without hurting others.
Check out the success California facilities have with CPI. 

Download a printable PDF with details on how
Nonviolent Crisis Intervention® training can help you meet these regulations.

Get started right away.

As you can see, CPI has you covered. You’ll find that our unparalleled training and support is all about practice, role-playing real-life scenarios, problem solving, and ongoing education to ensure the best solutions for your staff.