Risk Factors & Warning Signs
Verbal statements like “You better watch yourself” are an example of this type of warning sign
What is a verbal threat
Verbal threats should always be taken seriously because they can signal escalating risk
These should always be kept clear to ensure quick escape during escalation
What are exit routes
Clear exit routes help staff leave quickly if a situation becomes unsafe
This communication approach focuses on calm tone, non-threatening body language, and active listening.
What is de-escalation
De-escalation is a core skill; many incidents can be prevented by calm, respectful communication.
After a workplace violence incident, staff should enter a report into this reporting system.
What is Safety Always?
Timely reporting helps identify trends and hazards; under-reporting hides true risk and delays fixes.
This short discussion is held directly after a WPV event with staff involved to review what happened.
What is a Debrief
Debriefs help teams process the event and identify immediate lessons learned
A sudden change in behavior from calm to withdrawn or hostile may indicate this
What is Escalation
Sudden behavior changes can be an early warning sign that a person is escalating
Standing at an angle, keeping an exit accessible, and maintaining appropriate distance are examples of this safety concept.
What is positioning
Safe positioning reduces risk of being trapped and supports quick exit if the situation worsens.
This role is a key leader for coordination during a violent or escalating situation
What is the Admin Director, Unit Supervisor and/or Clinical Director (multiple choice)
All of these roles are critical for response coordination during a WPV event
This team (including security, nursing, and behavioral support specialist) responds rapidly to escalating violence on a unit.
What is the SAFE team?
Behavioral emergency and response teams provide coordinated support during high-risk situations.
These simulated exercises allow teams to practice responding to violent situations in a safe environment
What are mock drills
Mock drills build confidence and reveal gaps before a real event occurs
This emotional state often precedes aggression and may include frustration or fear
What is anxiety or distress
Anxiety and distress can quickly escalate into aggression if not recognized early.
Removing these from the room reduces risk of harm.
What are potential weapons
Environmental rounds identify items that could be used as weapons or for self-harm and guide mitigation steps.
This is the most important first step when a situation begins to escalate
What is staying calm and assessing the situation
Staying calm helps staff think clearly and choose the safest next step
True or False: Under VA law, assaulting a healthcare worker is a Class 1 Misdemeanor?
What is True
Assault incidents on team members are criminal offenses, not just “part of the job”
This type of huddle includes discussion of high-risk patients and behavioral safety concerns at the start of the shift
What is a safety or situational awareness huddle
Shift huddles help teams anticipate risk and plan proactively for safety concerns
This type of threat is spoken, written, gestured or symbolic.
What is an explicit threat?
Explicit threats are direct statements or actions that clearly communicate intent to harm
This is the recommended distance to maintain for personal safety
What is at least 2 arm lengths away
Maintaining at least two arm lengths of space gives staff more time to react safely
This action should be taken when a patient becomes physically violent
What is removing yourself from the immediate area/create distance
Creating distance is often the safest immediate action when violence becomes physical
This support resource may be offered to staff after a traumatic event
What is employee assistance/emotional support
Emotional support resources can help staff recover after a traumatic workplace violence event
This is the MOST important outcome of a mock drill—not just completing it
What is identifying gaps and improving real-world response
Identifying gaps and making concrete improvements is what turns drills into real-world safety gains
This type of threat is a subtle or indirect suggestion that something violent may happen without explicitly stating it.
What is an implied threat?
Implied threats may be vague, but they still require attention and reporting
This should never be between you and the exit during an interaction
What is the patient or aggressive individual
Staff should always keep themselves between the aggressive person and the exit
This procedure should be utilized for an inpatient refusing care, exhibiting physical violence or disruptive behavior
What is Administrative Discharge
Administrative Discharge may be considered when behavior creates ongoing safety risks and care cannot continue safely
This common failure in drills and real events leads to confusion and delayed response
What is lack of role clarity
Clear role assignments improve coordination, safety and reduce delays during emergencies
A multidisciplinary review of the care process with the goal of improving safety and reliability for every patient and team member we serve.
What is a HEAL Session?
HEAL sessions turn serious events into system improvements that strengthen safety and reliability