Authors: (including presenting author): :
Jim CH(1), Ho CM(1)
Affiliation: :
(1) Occupational Therapy Department, Tai Po Hospital
Keyword 1: :
Workplace Violence
Keyword 2: :
Occupational Safety and Health
Keyword 3: :
Staff Safety
Keyword 4: :
Staff Health
Introduction: :
Workplace violence remains a persistent challenge in psychiatric care, where occupational therapists frequently engage with patients experiencing severe behavioral dysregulation, agitation, or psychotic symptoms. These encounters heighten risks of impulsive aggression, including biting, scratching, and physical assaults. Protecting staff while sustaining therapeutic engagement is essential to service quality, resilience, and morale.
Objectives: :
To strengthen staff preparedness and reduce workplace violence risks in the Occupational Therapy Department through a layered prevention framework integrating primary, secondary, and tertiary strategies.
Methodology: :
Interventions were structured across three preventive layers: 1) Primary Prevention – Proactive Risk Reduction: Staff received pre-drill training and e-learning on de-escalation techniques, supported by continuously updated guidelines. 2) Secondary Prevention – Early Detection and Rapid Response: Annual workplace violence drills with hospital security clarified workflows and strengthened interdisciplinary coordination. Staff observed ward-based drills, which enhanced cross-disciplinary learning. Real-time monitoring through doorbell cameras in psychiatric treatment areas ensured safety and timely support for staff during emergency situations. 3) Tertiary Prevention – Minimizing Harm Post-Incident: Bite- and scratch-resistant gloves and forearm sleeves were introduced in the learning disability ward, reducing injury while maintaining therapeutic flexibility.
Result & Outcome: :
A staff survey using a 0–10 rating scale was conducted to evaluate the framework. Twenty-nine psychiatric staff participated, and responses were positive, with most items scoring between 8 and 10. Primary strategies were rated highly for improving knowledge (M=8.4, SD=1.3) and risk awareness (M=8.7; SD=1.4). Secondary measures earned high ratings for effectively strengthening emergency preparedness (M=8.6, SD= 1.5), enhancing confidence in handling patients with high violent risk (M=8.6; SD=1.2) and promoting a higher sense of workplace safety (M=8.6, SD=1.4), while also contributing to further gains in knowledge (M=8.8, SD= 1.1) and awareness (M= 8.9, SD=1.1). Tertiary interventions were strongly endorsed by staff working in the learning disability ward (n=11) for boosting confidence in managing behaviorally challenging patients during treatment provision (M=8.6, SD=1.2). Incident reports demonstrated a clear reduction in workplace violence cases in Q4 2025–Q1 2026, with no incidents occurring after full implementation of the framework, compared with two incidents in Q1–Q3 2025. Overall, the framework was regarded as effective in reducing risks, reinforcing staff confidence, and cultivating a supportive safety culture. Future refinements may include expanding access to protective equipment, integrating simulation-based training, and enhancing digital monitoring systems. Continuous evaluation and staff feedback will remain essential to sustaining progress and adapting strategies to evolving challenges in psychiatric care.
