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Reducing inpatient aggression: does paying attention pay off?

Karen A Nolan1, Leslie Citrome

  • 1Nathan S Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA. nolan@nki.rfmh.org

The Psychiatric Quarterly
|October 24, 2007
PubMed
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Improved reporting of inpatient aggression, using therapy aides, significantly increased detection rates from 77% to 95%. This enhanced documentation may reduce physical aggression by enabling earlier intervention.

Area of Science:

  • Psychiatry
  • Behavioral Science
  • Health Informatics

Background:

  • Inpatient aggression is frequently underdocumented in clinical settings.
  • Audio/video surveillance offers detection but is resource-intensive.
  • Effective interventions are needed to improve aggression reporting.

Purpose of the Study:

  • To assess the impact of interventions on improving the reporting of aggressive incidents.
  • To evaluate changes in aggression patterns following reporting improvements.

Main Methods:

  • Systematic review of video recordings from a secure inpatient unit (2000 and 2005).
  • Interventions focused on enhancing the role of therapy aides in reporting.
  • Comparison of aggression incident documentation rates before and after interventions.

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Main Results:

  • Reporting of aggressive incidents improved significantly from 77% in 2000 to 95% in 2005.
  • The total number of aggressive incidents remained statistically unchanged.
  • A decrease in physical aggression and an increase in verbal aggression were observed.

Conclusions:

  • Interventions can substantially improve the documentation of inpatient aggression.
  • Enhanced reporting may indirectly reduce physical aggression by facilitating early recognition and intervention.
  • Therapy aide involvement is a key factor in improving reporting accuracy.