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Nurses’ short-term prediction of violence in acute psychiatric intensive care

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Björkdahl A, Olsson D, Palmstierna T. Nurses’ short-term prediction of violence in acute psychiatric intensive care.

Acta Psychiatr Scand 2005: 1–6. © 2005 Blackwell Munksgaard. Objective: 

To evaluate the short-term predictive capacity of the Brøset Violence Checklist (BVC) when used by nurses in a psychiatric intensive care unit. Method: 

Seventy-three patients were assessed according to the BVC three times daily. Violent incidents were recorded with the Staff Observation Aggression Scale, revised version.

An extended Cox proportional hazards model with multiple events and time-dependent covariates was estimated to evaluate how the highest BVC sum of the last 24 h and its separate items affect the risk for severe violence within the next 24 h. Results: 

With a BVC sum of one or more, hazard for severe violence was six times higher than if the sum was zero. Four of the six separate items significantly increased the risk for severe violence with hazard ratios between 3.0 and 6.3. Conclusion: 

Risk for in-patient violence in a short-term perspective can to a high degree be predicted by nurses using the BVC.

Keywords: aggression; in-patient; psychiatric nursing; psychiatry; risk assessment; risk management; violence

Document Type: Research Article


Affiliations: 1: Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institute 2: Department of Learning, Informatics, Management and Ethics (LIME) Karolinska Institute

Publication date: 2006-03-01

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