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Br J Psychiatry. 2008 Jul;193(1):44-50. doi: 10.1192/bjp.bp.107.045534.

Structured risk assessment and violence in acute psychiatric wards: randomised controlled trial.

Author information

  • 1Nursing and Social Education Research Unit, University Bern Psychiatric Services, Bolligenstrasse 111, Berne 60, Switzerland. Abderhalden@puk.unibe.ch

Abstract

BACKGROUND:

There is a lack of research on the possible contribution of a structured risk assessment to the reduction of aggression in psychiatric in-patient care.

AIMS:

To assess whether such risk assessments decrease the incidence of violence and coercion.

METHOD:

A cluster randomised controlled trial was conducted with 14 acute psychiatric admission wards as the units of randomisation, including a preference arm. The intervention comprised a standardised risk assessment following admission with mandatory evaluation of prevention in high-risk patients.

RESULTS:

Incidence rates decreased substantially in the intervention wards, whereas little change occurred in the control wards. The adjusted risk ratios suggest a 41% reduction in severe aggressive incidents and a 27% decline in the use of coercive measures. The severity of aggressive incidents did not decrease.

CONCLUSIONS:

Structured risk assessment during the first days of treatment may contribute to reduced violence and coercion in acute psychiatric wards.

PMID:
18700217
[PubMed - indexed for MEDLINE]
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