Using a specially designed risk assessment tool within 24 hours of admission was an effective way of identifying which hospital patients in medical and surgical units would become violent. Researchers studied more than 2,000 patients admitted to an acute care hospital over a five-month period. As well as identify the traits that were most likely to lead to violence, they found that a disproportionate number of elderly patients and males became violent.
Using a specially designed risk assessment tool was an effective way of identifying violent hospital patients in medical and surgical units, according to a study in the November issue of the Journal of Advanced Nursing.
American researchers led by Son Chae Kim, Professor of Nursing at Point Loma Nazarene University and Kristyn Ideker, a Registered Nurse at Scripps Memorial Hospital, San Diego, California, studied more than 2,000 patients admitted to an American acute care hospital over a five-month period.
"Patient violence occurs in all healthcare settings and, although a number of tools have been developed for use in psychiatric units, there is a lack of brief screening tools for medical and surgical settings" says Professor Kim.
"That is why we developed the ten-point Aggressive Behaviour Risk Assessment Tool (ABRAT), which was completed within 24 hours of admission and appears to provide a promising tool for predicting which patients will become violent during their hospital stay.
"For example less than one per cent of patients with an ABRAT rating of zero became violent, compared with 41 per cent of those with a rating of two or more.
"Two nurses completed an ABRAT rating for each patient, agreeing in 93 per cent and 96.5 per cent of cases on ABRAT scores with cut off points of one and two respectively."
Key findings of the study included:
The researchers quantified the ability of the ABRAT to predict violence in the medical and surgical settings by using the predictive value, where 100 per cent represents a perfect prediction.
The ABRAT included a number of items from the M55 tool, previously used in general acute care. It also drew on the STAMP concept, published in the Journal of Advanced Nursing in 2007, which covers staring and eye contact, tone and volume of voice, anxiety, mumbling and pacing.
Nurses who had undergone a training course in use of the tool collected the data from patients admitted to six different medical-surgical units.
"The results from this study indicate that the ten-item ABRAT could be useful in identifying potentially violent patients in medical-surgical units, with acceptable accuracy and agreement between users" says Professor Kim.
"Further studies are now needed to see whether the use of the ABRAT can actually reduce violence in clinical settings."
Cite This Page: