Hospitals

Policy Title:  No Hit Zone Policy in Children’s Hospitals

Purpose:

1. To create and reinforce an environment of comfort and safety for patients, families and staff.
2. To provide clear procedures for addressing situations in which adults are using physical discipline with children, or to de-escalate a situation in which caregivers begin to raise their voices, or show other signs of stress and inappropriate behaviors that occur prior to physical discipline.

Policy:

1. The Hospital shall implement a “No Hit Zone” which is an environment in which no adult shall hit a child, no adult shall hit another adult, no child shall hit an adult, and no child shall hit another child.
   1. The policy will be implemented on all campuses and property including all owned and leased properties, buildings, grounds, parking garages, and parking lots.
2. When hitting is observed or threatened, it is everyone’s responsibility to interrupt the behavior as well as communicate system policy to those present.
3. Staff will not be expected to place themselves in a dangerous situation by confronting violent behavior; security or police should be notified through established procedures whenever staff has concern for their physical safety or the safety of patients, visitors or other staff.
   1. If necessary, social services or department vice-president should be notified through established procedures.

Procedure: Training and Reporting Procedures

Training and Prevention:

1. All staff will be made aware of hospital policy that is in place to ensure and reinforce an environment of comfort and safety.
2. All hospital staff will be provided training opportunities.
3. Materials provided during training will include: brochures, signage, and videos educating on the No Hit Zone.

Reporting and Response Procedure:

1. Staff will identify and respond to situations that compromise the safe environment utilizing the education they are provided with.
2. The following steps will be taken when hitting or other disruptive behavior is witnessed:

1. 1. Respond in a nonjudgmental way.
   2. Empathize with the frustrations and stress the involved individuals may be experiencing. Remind them that Children’s Hospital is a “No Hit Zone,” that is, no physical violence is tolerated.
   3. Try to have conversations with the involved individuals out of earshot of others, and if possible including the child, so the individual is not embarrassed.
   4. Avoid making threats.
   5. Thank the individual(s) for respecting our policies and offer written educational material as appropriate.
   6. For hospital patients, documentation of the behavior and any intervention/action should be documented in the record.
   7. If indicated by the situation, notify Child/Adult Protective Services in accordance with the Abuse Policy, as outlined in policy _____ and _______.
   8. If indicated by the situation, notify security for assistance.
   9. If indicated by the situation, follow the policy procedures outlined in _____ and ______ for reporting cases of Child Abuse or Neglect.

 

References:

• Frazier, E. R., Liu, G. C., & Dauk, K. L. (2014). Creating a safe place for pediatric care: a no hit zone.pediatric s, 1(4), 247 -250.
• Gershoff, E. T., Font, S. A., Taylor, C. A., Garza, A. B., Olson-Dorff, D., & Foster, R. H. (2018). A short-term evaluation of a hospital No Hit Zone policy to increase bystander intervention in cases of parent-to-child violence. Children and Youth Services Review, 94, 155–162. ​https://doi.org/10.1016/j.child youth .2018.09.040​.
• Vaughan-Eden, V., Holden, G. W., & LeBlanc, S. S., (2018). Commentary: Changing the social norm about corporal punishment. Child and Adolescent Social Work Journal, 32 (1). DOI 10.1007/s10560-018-0592-y
• LeBlanc, S., Alexander, R., Mastrangelo, M. & Gilbert, H. (2019). No hit zones: A simple solution to address the most prevalent risk factor in child abuse. ​APSAC Advisor,​ 31 (1), 37-51.