New guidelines address the safety of the remote health workforce

In the remote and isolated workplace, violence is an escalating concern that presents unique challenges not faced in urban areas. Following the tragic death of Remote Area Nurse colleague Gayle Woodford in March 2016, the drive to improve the safety and security of the remote health workforce became an industry wide priority.

This led the remote health industry to reflect critically on long held practices, and to challenge acceptance of the risks that had often been considered ‘just part of the job’.

In the 2016-17 financial year, CRANAplus received funding from the Australian Government Department of Health to undertake a remote health workforce safety and security project. A diverse representative expert advisory group informed the entire project.

Phase one of the project produced the National remote health workforce safety and security report: literature review, consultation, and survey results. The report included a literature review building on the work of the Working Safe in Rural and Remote Australia Project.

Additionally, through workshops, surveys and social media, CRANAplus undertook a ‘national conversation’ with remote health stakeholders. We sought the views of the workforce, employers, and other stakeholders, and tested existing assumptions on the real and perceived issues relating to safety and security.

The report identified a high workforce turnover and issues relating to bullying and harassment. It identified the need for employers and staff to conduct hazard identification and risk assessment, event reporting, and workplace reviews of significant events and near-misses. There is a need for staff to be accompanied on-call, and at other times when risks are identified; for reliable, accessible transport and emergency after-hours communication systems, supported by staff training in equipment use; and for access to patient information and data in staff accommodation. There must be more comprehensive and timely orientation of new staff, promotion of individual resilience and management of fatigue, and staff training and practice in communication and de-escalation techniques to mitigate the risk of conflict leading to violence.

The full report can be accessed under the professional Services tab of the CRANAplus website https://crana.org.au/professional/practice/safety-security-in-remote-healthcare

The Safety guidelines for remote and isolated health were released in May 2017. The Guidelines identify seven safety and security priority areas each of which is viewed through the lens of the individual, the team, the employer, the infrastructure, the environment and the culture and community, reflecting the complexity of factors influencing remote health safety and security. The Guidelines provide a structured pathway to identify risks and prioritise areas for improvement.

The Guidelines are available on the CRANAplus website at https://crana.org.au/professional/practice/safety-security-in-remote-healthcare

Other resources to be developed as part of the Project include:

• an industry handbook on working safe in remote health;
• an easy to use safety and security self-assessment tool;
• a free e-remote learning module on working safe in remote practice; and
• the CRANAplus App to include ‘being safe in remote’ information.

CRANAplus wishes to thank all the remote area nurses, remote area health staff and employers who contributed to this project, and the Expert Advisory Group who spent many hours providing input and advice.

We would like to acknowledge Gayle’s family, friends, colleagues, and the community of Fregon who continue to grieve her loss.