Duress alarms in healthcare

Background

Duress alarms in hospitals and other healthcare settings summon help in emergencies. Knowing the location of duress alarms and how to use them is essential for the safety of staff, patients and the public.

Employees in healthcare settings need to be provided with the most appropriate type of duress alarm, whether portable or fixed in place.

In addition to having the most appropriate alarms, employees need to know where to find duress alarms and how to use them. This includes permanent, agency, casual and reassigned employees.

Hospitals and healthcare settings are dynamic workplaces. Employees often work across different departments, wards and sites. WorkSafe has received reports of employees not being able to activate duress alarms in emergencies. This was because the employees did not know where to find or how to use the alarms.

Safety issues

Healthcare workers face an increased risk of work-related violence. Being unable to quickly activate a duress button might result in:

• delayed emergency response
• increased risk of physical and psychological harm to staff
• escalation of aggressive behaviour
• increased risk to bystanders and patients.

Recommended ways to control risks

The following control measures may help you control risks related to duress alarms:

Appropriate alarms

Duress alarms are generally static, where they are fixed in place, or portable, where they are carried or worn.

Employees in healthcare do not always work in the same fixed location. For example, they might have to provide care throughout a ward. In these situations, a portable duress alarm may be the most appropriate alarm. Employees can immediately activate a portable duress alarm in an emergency.

To work out the most appropriate duress alarm, consider:

• where the work is being done
• the risk of aggression or violence.

Employees should not wear portable duress alarms around their neck.

Testing

Test duress alarms at the start of each shift to ensure they work. Testing includes, for example:

• ensuring the device is on
• checking batteries are charged, if applicable
• confirming the alarm is transmitting properly.

Conduct regular audits to ensure duress buttons are unobstructed and working properly.

Orientation, induction and onboarding

Ensure all new, agency, casual, and reassigned staff receive a comprehensive orientation that includes the location and function of all duress buttons in their working area.

Handover

At the start of each shift, brief all staff on the location of duress alarms specific to the ward, clinic or area they are working in.

Visible signs

Clearly label all duress buttons with standardised, visible signs.

Training

Provide regular training on how and when to use duress alarms, including simulated drills.

Review and feedback

Encourage staff to report near misses and incidents where duress alarms did not work, were not accessible or their location not known.

Use incident reviews to identify gaps in knowledge or system issues regarding duress alarms.

Consult with employees and any health and safety representatives (HSRs) when making decisions about the type of duress alarms to use and where to put them.

Legal duties

Employers have duties under the Occupational Health and Safety Act 2004. These include duties to do the following, so far as is reasonably practicable:

• Provide and maintain a working environment that is safe and without risks to health.
• Ensure persons other than employees are not exposed to risks to their health and safety from the employer's conduct.
• Consult with employees and any HSRs when:
  • identifying or assessing hazards or risks
  • making decisions about risk control measures
  • proposing changes to the workplace, plant or work processes that may affect health and safety.

Employers must also provide employees with information, instruction, training or supervision as is necessary to perform their work safely and without risks to health.