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Association between short-term structured risk assessment outcomes and seclusion
Roland van de Sande1, Eric Noorthoorn, Andre Wierdsma
1Department of Health, Utrecht University of Applied Science, Utrecht, Netherlands; Acute Psychiatric Care, ParnassiaGroep, Capelle aan den Ijsel, Netherlands.
International Journal of Mental Health Nursing
|July 12, 2013
Summary
Structured risk assessments using the Brøset Violence Checklist (BVC) and Kennedy Axis V aid in identifying acute psychiatric patients at high risk for seclusion. These tools help reduce aggressive incidents and seclusion duration.
Area of Science:
- Psychiatry
- Clinical Psychology
- Risk Assessment
Background:
- Acute psychiatric patients exhibit fluctuating symptoms and behaviors.
- Structured risk assessments can mitigate aggressive incidents and seclusion duration.
- Clinical decision-making regarding seclusion requires valid observational tools.
Purpose of the Study:
- To validate the Brøset Violence Checklist (BVC) and Kennedy Axis V for seclusion-related clinical decisions.
- To assess the utility of structured observation tools in acute psychiatric settings.
Main Methods:
- Collected 7403 daily risk assessments over 10,725 admission days from 301 acute psychiatric patients.
- Utilized multilevel analysis on 7055 daily assessment scores.
- Examined dynamic and static factors associated with seclusion.
Main Results:
- Both dynamic and static factors correlated with seclusion risk.
- Dynamic factors: 'confusion' (BVC), psychological/social impairment (Kennedy Axis V).
- Static factors: non-Western descent, male, <35 years, unmarried, personality disorder.
- Dynamic factors explained a larger proportion of the variance in seclusion risk.
Conclusions:
- The Brøset Violence Checklist (BVC) and Kennedy Axis V are valuable in identifying patients at high risk for seclusion.
- Integrating these tools into standard practice can improve seclusion management.
- Dynamic risk factors are crucial predictors of seclusion.
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