Le aggressioni e la violenza contro gli operatori sanitari

Le aggressioni verso i lavoratori sono in aumento tanto che in aprile di quest’anno si è insediato al Ministero della Salute l’Osservatorio permanente per la garanzia della sicurezza e per la prevenzione degli episodi di violenza ai danni degli operatori sanitari.

Mi capita sempre più nell’ultimo anno di essere chiamata da Aziende Sanitarie a fare consulenza e formazione agli operatori per il riconoscimento e la gestione dei comportamenti aggressivi da parte di pazienti e/o caregivers.

Nel 2011 l’Agenzia  Europea per la Sicurezza e la Salute sul Lavoro (Eu-Osha, “Violenza e molestie su/luogo di lavoro:  un quadro europeo”), definiva per violenza sul lavoro tutti quegli atti che possono nuocere  all’equilibrio bio-psico-sociale del lavoratore (OMS). Gli atti sono:

–     insulti-comportamenti incivili;

–     minacce;

–     forme  di aggressione  psicologica;

–     forme di aggressione  fisica;

–      la presenza  di una componente razziale o sessuale.

Di fatto il rischio di aggressioni e violenze in ambito lavorativo si affianca oramai ai tradizionali rischi per la salute dei lavoratori e agli indicatori del benessere lavoro-correlato.

In sanità gli episodi di aggressione  sono considerati “eventi sentinella”, ovvero indicatori di situazioni di rischio e di vulnerabilità, come indica la Raccomandazione n.8/2007 del Ministero della Salute. In tale senso la Raccomandazione invita anche le Aziende sanitarie a fare un’adeguata formazione agli operatori oltre che ad attuare procedure di risk assessment e risk management. Il modello proposto è quello dell’incident reporting degli eventi avversi.

È ancora difficile per gli operatori ammettere di essere stati aggrediti, viene vissuto come indicatore di poca professionalità. Pochi solo coloro che denunciano, la maggior parte tace per vergogna, per pudore, per paura di ritorsioni da parte dei pazienti. Inoltre non tutte le Aziende sanitarie sembra abbiano recepito la Raccomandazione del Ministero della Salute e mettano in atto le adeguate strategie di tutela della sicurezza e della prevenzione allo stress lavoro-correlato.

Nei Corsi di formazione mi viene solitamente chiesto: quali sono gli indizi di un’escalation di violenza? Come uso le tecniche di de escalation della violenza? Ma anche: quali sono le azioni di prevenzione organizzativa e strutturale, quali protocolli operativi, la valutazione del rischio, la gestione delle criticità, e quali sono gli interventi sugli operatori dopo le aggressioni per attenuare gli esiti psicologici.

Per la sicurezza e la salute degli operatori sanitari sono misure organizzative e strutturali che devono essere messe in atto il prima possibile. Le domande e i bisogni degli operatori che emergono durante i Corsi sono proprio la cartina tornasole di questa necessità di salute.

Le aggressioni e la violenza non devono essere considerati dei rischi possibili per i lavoratori della sanità.

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