Incidents in a psychiatric forensic setting: association with patient and staff characteristics

Patient-related incidents are of particular concern for those working with forensic psychiatric populations. Evidence suggests that personality, stress, and burnout of nursing staff are predictive of incidents. However, the exact relationship of these factors with staff-patient interactions and the incidents that occur within these interactions have not been thoroughly explored. The authors collected data on the nature of incidents on a forensic unit within a psychiatric hospital over a 1-year period, as well as data on the characteristics of 13 staff members. They found that 10% of patients were responsible for 58% of the incidents. Patients with a diagnosis of schizophrenia were disproportionately involved in incidents. The frequency of non-violent incidents varied among nursing teams to an extent greater than that expected by chance. A relationship between incidents and some staff characteristics was also found. These results highlight the need for further research into the incidents that occur in situations where patient attributes, nurse attributes, and environmental factors produce complex interactions.