Citation

Abderhalden C, Needham I, Dassen TWN, Halfens R, Haug HJ, Fischer JE. Br. J. Psychiatry 2008; 193(1): 44-50.

Affiliation

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

Copyright

(Copyright © 2008, Royal College of Psychiatry)

DOI

10.1192/bjp.bp.107.045534

PMID

18700217

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.

Language: en