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Guidance on Reporting Incidents and Recommendations for Adequate Controls to Mitigate Workplace Violence in Medical Facilities

The purpose of this guidance is to provide background on the Workplace Violence in the Medical Industry regulation R044-20 as well as provide guidance on reporting requirements and adequate controls that an employer may utilize to comply with the requirements under R044-20.

NRS 618.7301 to 618.7318 was adopted in 2019 to address workplace violence at medical facilities. This legislation required the Division of Industrial Relations to adopt regulations. On December 21, 2021, regulation R044-20 was approved by the Legislative Commission, which became effective on
December 22, 2021.

Relevant sections of R044-20 are as follows:

  • Section 3 – Establishes time periods in which a medical facility (as defined under NRS 618.7305) is required to report certain incidents of workplace violence to the Division of Industrial Relations. Pursuant to R044-20(3), a medical facility is required to report to the nearest office of the Division:
    1. Any fatality, inpatient hospitalization, amputation or loss of an eye of an employee resulting from workplace violence in which physical force or a firearm or other dangerous weapon is used, not later than 8 hours after the time that the fatality, hospitalization, amputation or loss is reported to any agent or employee of the facility.
    2. Any incident of workplace violence in which physical force or a firearm or other dangerous weapon is used but no fatality or injury results, not later than 24 hours after the incident occurs.
    3. Any realistic possibility of workplace violence, not later than 30 days after the medical facility learns of the possibility.
  • Section 4 – Establishes requirements for procedures in a medical facility’s plan for the prevention of, and response to, workplace violence. Pursuant to R044-20(4), every plan for the prevention of and response to workplace violence which is developed pursuant to NRS 618.7312 must include procedures for the assessment of workplace violence hazards, as well as communication amongst law enforcement, paramedic, and other emergency medical transportation who are receiving patients who have been identified as having risk factors.
  • Section 5 – Establishes requirements for certain measures to prevent or mitigate risks of workplace violence. Pursuant to R044-20(5), “Any engineering control, work practice control or other appropriate measure which a medical facility implements to prevent or mitigate the risk of workplace violence as identified in an assessment of the workplace pursuant to section 4 of this regulation must, at a minimum, effectively address the hazardous conditions which constitute the risk.”
  • Section 6 – Establishes requirements for a medical facility to maintain, record and review a log of certain information relating to incidents of workplace violence. Pursuant to R044-20(6), “A medical facility shall maintain a log of workplace violence incidents and record in the log information about every incident, post-incident response and investigation regarding an injury resulting from workplace violence.”

Click here to read the full guidance including adequate controls, enforcement and additional resources.