Aggressive behaviour on acute psychiatric wards: prevalence, severity and management

Area of Science:

• Psychiatric Nursing
• Healthcare Safety
• Aggression Management

Background:

• Aggressive behavior in psychiatric settings threatens staff well-being and patient care.
• Fear among staff due to potential danger impacts the quality of care provided.

Purpose of the Study:

• To investigate the nature and prevalence of inpatient aggression towards staff and patients.
• To examine the methods used by nursing staff to manage patient self-harm and aggression.

Main Methods:

• Data collected by nursing staff on five acute inpatient wards over 10 months (June 2001-April 2002).
• Utilized the Staff Observation Aggression Scale - Revised (SOAS-R) to record incidents.

Main Results:

• 254 aggression incidents recorded; staff were targets in 57.1% of cases.
• Denial of privileges (e.g., ward leave) was the most common trigger (29.5%).
• Verbal aggression was most frequent (60%), leading to feelings of threat (59%); seclusion was used in 35.9% of staff-targeted incidents.

Conclusions:

• Nurses have a 1 in 10 annual risk of injury from patient aggression.
• Despite verbal aggression dominance, physical methods like seclusion are frequently employed due to staff fear and difficulty understanding aggression causes.