Aggression in Psychiatric Wards: Effect of the Use of a Structured Risk Assessment

Area of Science:

• Psychiatry
• Healthcare Management
• Patient Safety

Background:

• Healthcare workers in psychiatric settings face frequent violence and aggression.
• Short-term risk assessments, like the Brøset Violence Checklist (BVC), can predict aggression and inform preventive measures.

Purpose of the Study:

• To evaluate the impact of routine Brøset Violence Checklist (BVC) use on reducing patient aggression frequency in psychiatric wards.
• To assess the effectiveness of systematic short-term aggression risk assessment in a clinical setting.

Main Methods:

• A semi-random regression discontinuity design was employed across 15 psychiatric wards.
• The Brøset Violence Checklist (BVC) was implemented in seven intervention wards; eight control wards were used for comparison.
• Patient aggression risk was assessed using the Aggression Observation Short Form (AOS) at baseline and follow-up over three months.

Main Results:

• The regression discontinuity analysis indicated a 45% reduction in aggression risk (OR = 0.55), though this was not statistically significant.
• No significant reduction in patient aggression was observed after the systematic implementation of the Brøset Violence Checklist (BVC).

Conclusions:

• The routine use of the Brøset Violence Checklist (BVC) did not yield a statistically significant reduction in patient aggression in this study.
• While findings suggest a potential benefit, larger studies with increased statistical power are required to confirm the efficacy of the BVC in mitigating aggression.