Emergency department staff should be able to use pepper spray to de-escalate violent situations, a review into the safety and security of NSW hospitals has recommended.
The statewide review, undertaken by former NSW health and police minister Peter Anderson, looked at ways to better protect and safeguard the welfare of hospital staff, visitors and patients.
Staff from 44 hospitals across NSW, representatives from health unions, police, Corrective Services and Safework NSW were all consulted for the report, released on Monday.
Hospitals are facing increasing risks, it found, including dealing with angry or ice-affected patients and treating weapon-inflicted injuries.
"It was disturbing to say the least to hear during my hospital visits from experienced doctors and nurses about the increase in aggressive and violent behaviour that they are experiencing, and the apprehension this brings," Mr Anderson wrote in the report.
He noted recent examples of workers being forced to confront people armed with a knife or machete in emergency departments, but lamented the under-reporting of security issues by hospital staff.
Also among the 107 recommendations made by the review were that the mandatory wearing of personal duress alarmed be more strictly enforced and wait times for patient mental health assessments be slashed.
Treatment spaces should also be designed for patients deemed a behavioural risk and security staff must be warned when such a patient is en-route to the hospital.
The different challenges facing regional and rural hospitals should be the focus of its own review, Mr Anderson also recommended.
NSW Health Services Union Secretary Gerard Hayes said the report finally acknowledged the "violent horror" faced by hospital staff far too regularly.
"For the last two decades hospitals have become increasing violent, dangerous places to work," he said.
"Our members have been kicked, punched, shot, and stabbed."
"Just last month, a security assistant at Port Macquarie Hospital had a chunk of flesh torn from his torso when a patient bit him."
More permanent security staff are needed he said.
Health Minister Brad Hazzard said the government supported the majority of the report's recommendations, and would work to reduce the use of contract security staff, would hire more permanent staff, and boost security numbers in some rural and regional hospitals.