Aggression and seclusion on acute psychiatric wards: effect of short-term risk assessment

Short-term structured risk assessment is presumed to reduce incidents of aggression and seclusion on acute psychiatric wards. Controlled studies of this approach are scarce. To evaluate the effect of risk assessment on the number of aggression incidents and time in seclusion for patients admitted to...

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Bibliographic Details
Published in:British journal of psychiatry 2011-12, Vol.199 (6), p.473-478
Main Authors: van de Sande, R., Nijman, H. L. I., Noorthoorn, E. O., Wierdsma, A. I., Hellendoorn, E., van der Staak, C., Mulder, C. L.
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aggression
Aggression - psychology
Aggressiveness
Clinical assessment
Clinical decision making
Decision making
Female
Humans
Intervention
Male
Mental disorders
Mental Disorders - epidemiology
Mental Disorders - psychology
Mental Disorders - therapy
Mental health
Netherlands
Nurses
Patient admissions
Patients
Program Evaluation
Psychiatric Department, Hospital - organization & administration
Psychiatric Department, Hospital - statistics & numerical data
Psychiatric hospitals
Psychiatric Nursing
Psychiatric Status Rating Scales
Psychiatric units
Psychiatric-mental health nursing
Psychiatry
Regression Analysis
Relative risks
Restraint, Physical - utilization
Risk Assessment
Risk factors
Risk reduction
Seclusion
Severity of Illness Index
Short term
Social Isolation
Time Factors
Violence
Violence - prevention & control
Violence - psychology
Violence - statistics & numerical data
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Summary:Short-term structured risk assessment is presumed to reduce incidents of aggression and seclusion on acute psychiatric wards. Controlled studies of this approach are scarce. To evaluate the effect of risk assessment on the number of aggression incidents and time in seclusion for patients admitted to acute psychiatric wards. A cluster randomised controlled trial was conducted in four wards over a 40-week period (n = 597 patients). Structured risk assessment scales were used on two experimental wards, and the numbers of incidents of aggression and seclusion were compared with two control wards where assessment was based purely on clinical judgement. The numbers of aggressive incidents (relative risk reduction -68%, P
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.bp.111.095141