Summary: 

Effective: July 1, 2020  

Beginning in July of 2020, healthcare staff in the state of Nevada will be required to have training regarding workplace violence. Below is a summary of Assembly Bill 348 (AB 348) and information on how Safety-Care can be used to meet training needs and ensure the safety of staff and patients.

How Safety-Care aligns: Numerous health organizations throughout the United States and Canada rely upon QBS and our Safety-Care training to provide their staff members with the training they need to help maintain a safe and healthy environment. Safety-Care provides a comprehensive, supportive approach to incident prevention, de-escalation, and management. Your Staff will learn practical strategies for helping students that use evidence-based practices consistent with PBIS (Positive Behavior Interventions and Supports) and ABA (Applied Behavior Analysis).  

Safety-Care can meet the requirements of Departmental Requirements in the following ways: 

Intent of Legislation  

Section 14: Development of Prevention Plan  

1. A medical facility shall: 

(a) Establish a committee on workplace safety, which must consist of:  

(1) If a staffing committee has been established for the medical facility pursuant to NRS 449.242 or an applicable collective bargaining agreement:

(I) The members of the staffing committee; and  
(II) Employees of the medical facility who work in areas of the medical facility other than those represented on the staffing committee, appointed by the operator of the medical facility.  

(2) If a staffing committee has not been established for the medical facility pursuant to NRS 449.242 or an applicable collective bargaining agreement, employees of the medical facility appointed by the operator of the medical facility. Such employees must include, without limitation, employees who work in all major areas of the medical facility.  

(b) Develop and maintain a plan for the prevention of and response to workplace violence. The plan must: 

(1) Be in writing;  
(2) Be in effect at all times;  
(3) Be available to be viewed by each employee of the medical facility or other provider of care at the medical facility at all times;  
(4) Be specific for each unit, area and location maintained by the medical facility; and  
(5) Be developed in collaboration with the committee on workplace safety established pursuant to paragraph (a).  

3. The plan developed pursuant to paragraph (b) of subsection 1 must include, without limitation:  

(a) A requirement that all employees of the medical facility and other providers of care at the medical facility receive the training described in section 15 of this act concerning the prevention of workplace violence:  

(1) Upon the adoption of a new plan for the prevention of workplace violence;  
(2) Upon commencing employment and annually thereafter;  
(3) Upon commencing new job duties in a new location of the medical facility or a new assignment in a new location of the medical facility; and  
(4) When a previously unrecognized hazard is identified or there is a material change in the facility requiring a change to the plan.  

(b) Procedures that meet the requirements of section 16 of this act for responding to and investigating incidents of workplace violence. 

(c) Procedures that meet the requirements of the regulations adopted pursuant to section 18.5 of this act for assessing and responding to situations that create the potential for workplace violence.  

(d) Procedures for correcting hazards that increase the risk of workplace violence, including, without limitation, using engineering controls that are feasible and applicable applicable to the medical facility and work practice controls to eliminate or minimize exposure of employees and other providers of care to such hazards. 

(e) Procedures for obtaining assistance from security guards or public safety agencies when appropriate.

(f) Procedures for responding to incidents involving an active shooter and other threats of mass casualties through the use of plans for evacuation and sheltering that are feasible and appropriate for the medical facility.  

(g) Procedures for annually assessing, in collaboration with the committee on workplace safety established pursuant to paragraph (a) of subsection 1, the effectiveness of the plan.  

How Safety-Care aligns: Safety-Care is uniquely designed to provide trainees with the skills to assess potential crises, how de-escalate these situations, and how to respond if the situation is elevated. Our trainings are trauma-informed and focus on modifying behavior to prevent dangerous outcomes. Safety-Care can be taught to all levels of personnel, from administration down to volunteers. Additionally, our core trainings can be supplemented with unique add-on trainings focused on specific needs and professions. Safety-Care uses a Train the Trainer model allowing each district to quickly develop their own core of trainers qualified in the most current behavioral interventions and de-escalation strategies. Our Master Trainers can have up to ten (10) staff ready to train in as little as three days.  Safety-Care is geared towards ensuring that all trainees are familiar with a single response system and can respond in-kind to numerous situations regardless of the professional setting.  

Section 15: Training Requirements 

1. The training provided under the plan developed pursuant to paragraph (b) of subsection 1 of section 14 of this act must address the risks of workplace violence that an employee or other provider of care may be reasonably anticipated to encounter on his or her job and must include, without limitation, instruction concerning:  

a. An explanation of the plan, the manner in which the medical facility plans to address incidents of workplace violence, the manner in which an employee may participate in reviewing and revising the plan and any information necessary for employees and other providers of care to perform the duties that may be required of each employee or other provider of care under the plan;  
b. Recognizing situations that may result in workplace violence;  
c. When and how to respond to and seek assistance in preventing or responding to workplace violence; 
d. Reporting incidents of workplace violence to the medical facility and public safety agencies when appropriate; 
e. Resources available to employees and other providers of care in coping with incidents of workplace violence, including, without limitation, debriefing processes established by the medical facility for use after an incident of workplace violence and available programs to assist employees and other providers of care in recovering from incidents of workplace violence; and  
f. For each employee or other provider of care who has contact with patients, training concerning verbal intervention and de-escalation techniques that:  

(1) Allows the employee or other provider of care to practice those techniques with other employees and other providers of care with whom he or she works; and  

(2) Includes a meeting to debrief each practice session conducted pursuant to subparagraph (1).  

2. A medical facility shall collaborate with the committee on workplace safety established pursuant to paragraph (a) of subsection 1 of section 14 of this act in developing, reviewing and revising the training provided under the plan developed pursuant to paragraph (b) of subsection 1 of section 14 of this act and any curricula or materials used in that training.  

How Safety-Care aligns: Safety-Care initially focuses on incident minimalization, in an effort to support positive behaviors and reduce risks. Physical safety training is focused on staff’s situational awareness and physical protection within their work environments. It includes safety techniques aimed at preventing common staff injuries and includes relevant role-plays. Finally, physical management techniques are taught.  These techniques focus on a least-to-most restrictive process, emphasizing natural positioning, minimal intrusiveness, and the safety of all involved parties. 

Section 16: Responding and Investigating Incidents of Workplace Violence 

The procedures for responding to and investigating incidents of workplace violence included in the plan adopted pursuant to paragraph (b) of subsection 1 of section 14 of this act must include, without limitation, procedures to:  

2. Ensure an effective response to each incident of workplace violence, including, without limitation, by ensuring that members of the staff of the medical facility are trained to address such incidents and designated to be available to immediately assist in the response to such an incident without interrupting patient care;  

4. Identify each employee or other provider of care involved in an incident of workplace violence;  

5. Offer counseling to each employee and other provider of care affected by an incident of workplace violence; 

6. Offer the opportunity for each employee and other provider of care, including, without limitation, supervisors and security guards, involved in an incident of workplace violence to debrief as soon as possible after the incident at a time and place that is convenient for the employee or other provider of care;  

7. Review any patient-specific risk factors and any measures specified to reduce those factors; 

8. Review the implementation and effectiveness of corrective measures taken under the plan; and  

9. Solicit the feedback of each employee or other provider of care involved in an incident of workplace violence concerning the precipitating factors of the incident and any measures that may have assisted in preventing the incident.  

Section 17: Requirements for Developing and Reporting Incidents of Workplace Violence 

1. A medical facility shall:  

a. Ensure that the plan developed pursuant to paragraph (b) of subsection 1 of section 14 of this act is effectively implemented at all times and in all units, areas and locations of the medical facility.  

b. Coordinate risk assessment and development and implementation of the plan developed pursuant to paragraph (b) of subsection 1 of section 14 of this act with employees who provide care in the medical facility.  

c. Implement engineering controls, work practice controls and other appropriate measures, as applicable, to prevent and mitigate the risk of workplace violence in all units, areas and locations of the facility. Such controls must meet the requirements prescribed in the regulations adopted pursuant to section 18.5 of this act.  

2. A medical facility shall:  

a. Encourage employees and other providers of care to report incidents of workplace violence and concerns about workplace violence and seek the assistance of a public safety agency in accordance with the plan developed pursuant to paragraph (b) of subsection 1 of section 14 of this act to respond to an incident of workplace violence; and

b. Report to the Division any incident of workplace violence that:  

(1) Involves the use of physical force against an employee or other provider of care by a patient or a person accompanying a patient;  

(2) Involves the use of a firearm or other dangerous weapon; or  

(3) Presents a realistic possibility of death or serious physical harm to an employee or other provider of care.  

10. A medical facility shall not prohibit an employee or other provider of care from reporting incidents of workplace violence or concerns about workplace violence or seeking the assistance of a public safety agency to respond to an incident of workplace violence in accordance with the plan developed pursuant to paragraph (b) of subsection 1 of section 14 of this act.  

How Safety-Care aligns: Safety-Care requires that all trainees comply with local laws and regulations regarding reporting and debriefing. Additionally, Safety-Care’s Trainer Connect program can be used to assist in documenting interactions where Safety-Care has been utilized.   

Section 18-18.5: Recording Requirements  

1. A medical facility shall maintain and make available to the Division upon request records related to incidents of workplace violence and actions taken in compliance with sections 14 to 18.5, inclusive, of this act and the regulations adopted pursuant thereto. Such records must include, without limitation:  

(a) Records of the identification, evaluation and correction of hazards that increase the risk of workplace violence.  
(b) A record of workplace violence which meets the requirements prescribed by the regulations adopted pursuant to section 18.5 of this act.  
(c) A record of each training session provided under the plan developed pursuant to paragraph (b) of subsection 1 of section 14 of this act.  
(d) A record of each report to the Division pursuant to paragraph (b) of subsection 2 of section 17 of this act.  
(e) Any additional information required by regulation of the Division.  

2. Records maintained pursuant to sections 14 to 18.5, inclusive, of this act and the regulations adopted pursuant thereto must not include the personally identifiable information of any patient, employee of the medical facility or other provider of care at the medical facility. Such records must not be maintained or disclosed in a manner that violates NRS 449A.112 or the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, and any regulations adopted pursuant thereto.  

Sec. 18.5. 1. The Division shall, in consultation with the Division of Public and Behavioral Health of the Department of Health and Human Services, define by regulation the term “unit” for the purposes of sections 2 to 19, inclusive, of this act.  

Section 18.5 2. In addition to the regulations adopted pursuant to subsection 1, the Division shall adopt regulations that:  

(a) Prescribe minimum requirements for the procedures for assessing and responding to situations that create the potential for workplace violence included in the plan adopted pursuant to paragraph (b) of subsection 1 of section 14 of this act.  

(b) Prescribe minimum requirements for the engineering controls, work practice controls and other appropriate measures to prevent and mitigate risk of workplace violence carried out pursuant to section 17 of this act.  

(c) Prescribe the required contents of a record of workplace violence maintained pursuant to section 18 of this act.