Free Hospital Workplace Violence Incident Report Template
Hospital Workplace Violence Incident Report
I. Incident Overview
Date: May 15, 2050
Time: 10:30 AM
Location: Emergency Room
Reporter: Dr. Emily Johnson
Witnesses: Nurse Rodriguez, Security Guard Smith
Severity: Moderate
Description:
A patient became agitated while waiting for treatment in the emergency room. Despite attempts to calm him down, he became verbally abusive and then physically assaulted Nurse Rodriguez.
II. Actions Taken
A. Immediate Response:
-
Security was called immediately.
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Staff members were evacuated from the area.
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Emergency medical services were contacted.
B. Follow-up Actions:
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Reviewed security footage to identify the perpetrator.
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Conducted interviews with witnesses and staff involved.
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Notified law enforcement and filed a report.
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Offered counseling services to affected staff members.
III. Injuries and Damages
A. Injuries:
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Nurse Rodriguez suffered a minor concussion.
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The patient sustained a broken arm during the altercation.
B. Damages:
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Medical equipment was damaged during the scuffle.
IV. Recommendations
A. Preventive Measures:
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Increase security presence in high-risk areas.
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Provide staff with additional training on de-escalation techniques.
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Implement a zero-tolerance policy for workplace violence.
B. Security Improvements:
|
Action |
Deadline |
Responsible Party |
|---|---|---|
|
Install panic buttons in key areas |
June 30, 2050 |
Security Team |
|
Upgrade surveillance cameras |
July 15, 2050 |
IT Department |
|
Conduct regular security drills |
August 15, 2050 |
HR Department |
V. Conclusion
The incident has been documented and appropriate actions have been taken to address the situation. Continued vigilance and proactive measures are necessary to ensure the safety and security of all staff and patients.
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