Implementation of the Brøset Violence Checklist on an Acute Psychiatric Unit

J Am Psychiatr Nurses Assoc. Nov/Dec 2019;25(6):476-486. doi: 10.1177/1078390318820668. Epub 2019 Jan 13.

Abstract

BACKGROUND: Violence on inpatient psychiatric settings has significant consequences for patients and staff. Research is needed to determine if Brøset Violence Checklist (BVC) is an accurate predictor of violence. AIMS: The study aims were to determine the relationship between BVC scores and incidence of violent behavior within 24 hours, to compare scores among those requiring high-level nursing interventions for violence, and to investigate the impact of scores on length of stay (LOS) and 30 day-readmission rates. METHOD: Retrospective cohort study. RESULTS: Logistic regression indicates 3.4 times greater risk of violence for every additional point on admission BVC (odds ratio = 3.4, 95% confidence interval = [2.29, 5.08], p < .0001). Patients requiring high-level interventions for violence had higher mean BVC scores on both Day 1 and 2 of admission. Pearson correlation was significant for positive association between BVC on admission and LOS (p < .001). Findings did not establish a link between BVC scores and violence with 30-day readmission rates. CONCLUSIONS: Efforts toward early identification and management of agitation and disruptive behavior is encouraged. Results showed increased risk of violence with every additional point on BVC on admission; further attention should be paid to these patients on admission when using violence screening tools.

Keywords: hospitalization; inpatient treatment; rating scale and scales; violence/aggression.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aggression / psychology*
  • Checklist / methods*
  • Checklist / standards
  • Cohort Studies
  • Female
  • Hospitals, Psychiatric
  • Humans
  • Inpatients / psychology*
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data
  • Psychiatric Nursing / methods*
  • Reproducibility of Results
  • Retrospective Studies
  • Violence / prevention & control*
  • Young Adult