Aggressive Patient SWMS

Patient and visitor aggression is the fastest-growing source of workplace injury in Australian healthcare, with assault-related claims increasing year on year across hospitals, aged care, mental health, and disability services. Aggression ranges from verbal abuse and threats through to physical assault causing serious injury. The unpredictable nature of patient aggression — driven by pain, medication effects, cognitive impairment, mental illness, and substance intoxication — means that controls must be systematic and embedded in every patient-facing role. This template covers aggression management from prevention through to post-incident response with controls mapped to the binding Healthcare Code effective 1 July 2026.

Legal Requirements

regulation

WHS Regulation 2025 Part 3.1 — Psychosocial Hazards (Reg 55C); Healthcare Code 2026

hrcw category

Violence and aggression (psychosocial hazard)

code of practice

Healthcare Code of Practice 2026 (binding 1 July 2026 under Section 26A)

section 26a binding

Yes — Healthcare code binding July 2026. Non-compliance is a standalone offence.

Hazards

Hazard	Consequence	Likelihood
Physical assault by patient during clinical care or behavioural episode	Fractures, soft tissue injuries, head injuries, psychological trauma	Likely
Verbal abuse and threats from patients and visitors	Psychological injury, anxiety, PTSD	Likely
Injuries during physical restraint of aggressive patient	Muscle strain, bites, scratches, joint injuries	Possible
Weapon use by patient (improvised or concealed)	Penetrating injuries, severe lacerations, fatality	Unlikely
Secondary psychological harm from witnessing assault on colleagues	Vicarious trauma, anxiety, PTSD	Possible

Controls (Hierarchy of Controls)

Conduct patient aggression risk assessment on admission and update with changes in condition

Provide de-escalation training to all patient-facing staff with annual refresher

Install duress alarm systems accessible from every clinical area

Design clinical spaces with two exits, clear sight lines, and removal of potential weapons

Establish code response team with defined roles and rapid response capability

Implement post-incident support including critical incident debriefing and psychological first aid

Maintain aggression incident register with trend analysis and systemic control review

Recent Prosecutions

SafeWork NSW v Aged Care Provider$300,000

Worker seriously assaulted by resident with known history of aggression. Facility had no aggression risk assessment, no duress alarms, and no de-escalation training program.

2023 — SafeWork NSW Prosecution Database

What Your SWMS Must Include

✓Patient aggression risk assessment procedure with flagging system

✓De-escalation training requirements and annual refresher schedule

✓Duress alarm system specification and testing requirements

✓Code response procedure with team composition and response timeframes

✓Post-incident support protocol including debriefing and psychological first aid

Need a compliant Aggression Management SWMS?

Our WHS consultants develop aggression management SWMS with de-escalation frameworks, duress systems, and post-incident support protocols.