The validity and utility of violence risk assessment tools to predict patient violence in acute care settings: An integrative literature review

Abstract

To examine risk assessment tools to predict patient violence in acute care settings. An integrative review of the literature. Five electronic databases – CINAHL Plus, MEDLINE, OVID, PsycINFO, and Web of Science were searched between 2000 and 2018. The reference list of articles was also inspected manually. The PICOS framework was used to refine the inclusion and exclusion of the literature, and the PRISMA statement guided the search strategy to systematically present findings. Forty‐one studies were retained for review. Three studies developed or tested tools to measure patient violence in general acute care settings, and two described the primary and secondary development of tools in emergency departments. The remaining studies reported on risk assessment tools that were developed or tested in psychiatric inpatient settings. In total, 16 violence risk assessment tools were identified. Thirteen of them were developed to assess the risk of violence in psychiatric patients. Two of them were found to be accurate and reliable to predict violence in acute psychiatric facilities and have practical utility for general acute care settings. Two assessment tools were developed and administered in general acute care, and one was developed to predict patient violence in emergency departments. There is no single, user‐friendly, standardized evidence‐based tool available for predicting violence in general acute care hospitals. Some were found to be accurate in assessing violence in psychiatric inpatients and have potential for use in general acute care, require further testing to assess their validity and reliability.

Does workplace violence, empathy, and communication influence occupational stress among mental health nurses?

“…In the past decade, several violence risk‐assessment instruments have been developed, validated, and deployed to screen high‐risk patients (Ghosh et al . 2019). Additionally, training programmes were undertaken to strengthen nurses’ techniques and skills for violence prevention and control (Bromley & Painter 2019).…”

Wahnhafte Missidentifikation und gewalttätiges Verhalten – Risikoabschätzung und Management

“…Die aktuelle S3-Leitlinie "Verhinderung von Zwang: Prävention und Therapie aggressiven Verhaltens bei Erwachsenen" empfiehlt außerdem den Einsatz von Vorhersageinstrumenten für aggressives Verhalten wie der "Broset Violence Checklist" [36,37] oder der "Dynamic Appraisal of Situational Aggression" [38,39] in der klinischen Routinediagnostik [40]. Daneben existiert noch eine Reihe weiterer Checklisten und Fragebögen, um das Gewaltpotenzial von Patienten mit psychischen Erkrankungen einzuschätzen [41]. Feindseligkeit lässt sich symptomatisch auch aus der Erhebung der "Positive and Negative Syndrom Scale" -PANSS [42] oder mit dem Hostilitätssyndrom nach dem AMPD [43] strukturell gut erfassen und als Zielsymptomatik für therapeutische Interventionen benennen.…”

Response to Ghosh et al

“…A recent review article in the International Journal of Mental Health Nursing addressed the validity and utility of risk assessment tools for violence in acute care settings (Ghosh et al, 2019). Five electronic databases were searched between 2000 and 2018, and of 379 records identified, 41 studies met the inclusion criteria, and 16 risk assessment tools were identified.…”

“…The V‐RISK‐10 has been investigated and presented in three publications on predictive validity for violence risk assessment among patients admitted to acute psychiatric wards. However, two V‐RISK‐10 studies (Eriksen et al ., 2016 and Hartvig et al , 2011) were presented as Ps33 studies by Ghosh et al (Table 1, Ghosh et al, 2019). In the discussion section of the review, they mention that the Ps33 had been reduced to 10 items and given a new name, the V‐RISK‐10.…”

“…Our aim with this short comment was to inform that (i) The Ps33 was only a step on the way to develop a brief screening tool, the V‐RISK‐10. (ii) The results from studies of predictive validity referred in the review by Ghosh et al (2019) were not based on research on the Ps33, and (iii) research on the V‐RISK‐10 has shown significant predictive accuracy in general psychiatric acute wards.…”