Violence in intensive care: a point prevalence study.

Area of Science:

• Critical Care Medicine
• Healthcare Management
• Patient Safety

Background:

• Violence in intensive care units (ICUs) is under-researched, with incidence data often extrapolated from emergency departments.
• Existing jurisdictional policies for managing ICU violence lack formal evaluation.
• Understanding the scope and contributing factors of ICU violence is crucial for developing effective interventions.

Purpose of the Study:

• To determine the incidence and characteristics of patient violence in Australasian ICUs.
• To identify perceived contributors to violent behavior among ICU patients.
• To assess current management strategies and unit policies related to violence in the ICU.

Main Methods:

• A multisite, observational study across 44 Australasian ICUs.
• Collected data on patient violence incidence in the preceding 24 hours.
• Surveyed unit policies and management strategies for patient violence.

Main Results:

• 4% of 627 patients exhibited violent behavior in the 24 hours prior to data collection.
• Violence was associated with longer hospital and ICU stays.
• Confusion, physical illness, and psychiatric illness were the most common perceived contributors; chemical sedation and physical restraint were frequent management strategies.

Conclusions:

• Patient violence is a frequent occurrence in ICUs, necessitating interventions.
• A significant proportion of ICUs (32%) lacked documented violence management procedures.
• Considerable variation exists in violence management policies among ICUs that do have them.