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NSQHS Action 5.34, the line about the shift where somebody raises their voice
Aggression at a bedside or a triage counter has its own action in the national standards every Australian hospital is assessed against. This page is about that action, what it asks, and how staff practise it without anyone getting hurt.
Where it sits
One of the standards, and the one about comprehensive care
The National Safety and Quality Health Service Standards are set by the Australian Commission on Safety and Quality in Health Care. Action 5.34 sits in the Comprehensive Care Standard.
The action with a line in the incident reports
Most actions in the standards are about systems. This one is about a moment: the relative who arrives angry at a bedside, the triage counter late in the evening, the corridor update that goes wrong. The last three words of the action are the ones staff feel.
A hospital is assessed on whether it has processes for that moment, not on whether it has a policy about it. Processes are things people have done, which is why practice matters more here than on almost any other line.
What Action 5.34 says
In the Commission's own words
Quoted from the Comprehensive Care Standard on the Commission's own site, and linked below.
What the action asks, in one moment
Action 5.34 states that the health service organisation has processes to support collaboration with patients, carers and families to identify patients at risk of becoming aggressive or violent, implement de-escalation strategies, and safely manage aggression and minimise harm to patients, carers, families and the workforce. That is the entire action, quoted word for word.
Three verbs, and only the first can be done at a desk. Implementing a de-escalation strategy and safely managing aggression are things a person does with their voice, their hands and their distance, in a room, with someone who is not calm. Staff rehearse those steps in occupational violence and aggression training and VR de-escalation training.
How it is practised
Nobody in the room gets hurt, as often as it takes
The processes the action asks for are strategies people have rehearsed, not documents they have read.
PTR builds those strategies as scenarios: the relative who arrives angry, the counter late at night, the update in the corridor. A person who reacts the way people actually do stands opposite, the exchange can be run as many times as it takes, and every run is recorded against the staff member who did it.
That record is what an assessor reads when they ask how the hospital meets this action, and it lives inside the mandatory training program the hospital already runs, which is what Action 1.20 asks for. The two lines are built to be met together.
What people ask about this action
The questions that follow a first reading of it.
Is this the same thing as occupational violence training?
Action 5.34 never uses that phrase. It asks a health service for three things: identify the patients at risk of becoming aggressive or violent, implement de-escalation strategies, and safely manage aggression so that nobody is harmed. Whatever a service calls the problem on its own incident form, those three verbs are what an assessor asks it to show.
Where does a code black fit?
At the end of it. The action is written about the part before: seeing the risk while there is still room to do something about it, and de-escalating while a conversation is still a conversation. Practice gives staff that stretch of the shift back, as often as they want to run it.
We have a policy on aggression. Is that not enough?
A hospital is assessed on whether it has processes for that moment, not on whether it has a policy about it. A process is something people have done, which is why practice matters more on this line than on almost any other.
What does a hospital actually show an assessor?
A record of the practice, against the names of the people who did it, sitting inside the mandatory training program Action 1.20 asks for. That is the same record the director who owns that program takes upward when somebody asks how the service meets this line.
Preparing for NSQHS assessment?
Source
The standard this page quotes, on the Commission's own site.
Comprehensive Care Standard, Action 5.34
The health service organisation has processes to support collaboration with patients, carers and families to identify patients at risk of becoming aggressive or violent, implement de-escalation strategies, and safely manage aggression and minimise harm to patients, carers, families and the workforce.
