Risk assessment and subsequent nursing interventions in a forensic mental health inpatient setting: Associations and impact on aggressive behaviour

Maguire, Tessa; Daffern, Michael; Bowe, Steven J.; McKenna, Brian

doi:10.1111/jocn.14107

Cited by 27 publications

(39 citation statements)

References 64 publications

(108 reference statements)

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“…) was developed to provide structured recommendations for how and when (according to DASA risk level) nursing interventions might be instigated (Maguire et al . ). The Aggression Prevention Protocol is based on results from Maguire et al .…”

Section: Methodsmentioning

confidence: 97%

“…A critical limitation of extant risk assessment and aggression management research and practice has also been the absence of specific details about which aggression prevention strategies should be implemented, and when they should be applied (Maguire et al 2018). The DASA does not provide instructions for intervention following assessment; for example, it is unclear whether particular interventions are appropriate for patients at different risk levels.…”

Section: Risk Assessment Instrumentsmentioning

confidence: 99%

“…One commonly used intervention is the administration of Pro Re Nata (PRN), 'as necessary', medication. Requests by staff for patients to take PRN medication can lead to conflict (Bowers et al 2015;Nicholls et al 2009) and may also be associated with an increased likelihood of aggression in patients assessed at low risk of aggression (Maguire et al 2018). Uncertainty regarding suitable aggression prevention interventions may also lead to uncertainty in practice (Stevenson et al 2015).…”

Section: Risk Assessment Instrumentsmentioning

confidence: 99%

“…) and may also be associated with an increased likelihood of aggression in patients assessed at low risk of aggression (Maguire et al . ). Uncertainty regarding suitable aggression prevention interventions may also lead to uncertainty in practice (Stevenson et al .…”

Section: Introductionmentioning

confidence: 97%

“…To remedy these limitations, we developed an Aggression Prevention Protocol (see Maguire et al . ). In a study by Maguire et al .…”

Section: Introductionmentioning

confidence: 97%

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Evaluating the impact of an electronic application of the Dynamic Appraisal of Situational Aggression with an embedded Aggression Prevention Protocol on aggression and restrictive interventions on a forensic mental health unit

Maguire

Daffern

Bowe

et al. 2019

Int J Mental Health Nurs

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Risk assessment is a pre‐requisite for violence prevention in mental health settings. Extant research concerning risk assessment and nursing intervention is limited and has focused on the predictive validity of various risk assessment approaches and instruments, with few attempts to elucidate and test interventions that might prevent aggression, and reduce reliance on coercive interventions. The integration of risk assessment and violence prevention strategies has been neglected. The aim of this feasibility study was to test a novel Aggression Prevention Protocol designed to prioritize the instigation of less restrictive interventions on an acute forensic mental health unit for female patients. A prospective quasi‐experimental study was designed to test an Aggression Prevention Protocol, linked to an electronic application of the Dynamic Appraisal of Situational Aggression (DASA). Following introduction of the DASA and Aggression Prevention Protocol, there were reductions in verbal aggression, administration of Pro Re Nata medication, the rate of seclusion, and physical and mechanical restraint. There was also an increase in documented nursing interventions. Overall, these results support further testing of the electronic application of the DASA and the Aggression Prevention Protocol.

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Section: Methodsmentioning

confidence: 97%

Section: Risk Assessment Instrumentsmentioning

confidence: 99%