This study examined the use and effectiveness of the Alert assessment form. The form is part of the Alert system, used by one large acute care hospital to identify patients with a propensity for violence. All reported incidents of patient violence from August 1, 2003, through December 31, 2004, were included in patient charts. One hundred seventeen violent patient charts were reviewed and compared with 161 non-violent patient charts, randomly chosen from the same time period. Overall use of the Alert assessment form for violent and non-violent patients was 75.7% and 35.4%, respectively. The assessment form was found to have moderate sensitivity (71%) and high specificity (94%). It is reasonably effective in identifying potentially violent or aggressive patients when it is used according to protocol. Efforts to improve the tool are warranted, as is evaluation of its benefit in settings with low prevalence of violence. Also, greater effort must be taken to prevent violence once an aggressive patient has been identified.
References
1.
AlmvikR.WoodsP.RamussenK. (2000). The Brøset Violence Checklist: Sensitivity, specificity, and interrater reliability. Journal of Interpersonal Violence, 15(12), 1284–1296.
2.
ArnetzJ. E.ArnetzB. B. (2000). Implementation and evaluation of a practical intervention programme for dealing with violence towards health care workers. Journal of Advanced Nursing, 31(3), 668–680.
3.
BoydN. (1995). Violence in the workplace in British Columbia: A preliminary investigation. Canadian Journal of Criminology, 37(4), 491–519.
4.
CowinL.DaviesR.EstallG.BerlinT.FitzgeraldM.HootS. (2003). De-escalating aggression and violence in the mental health setting. International Journal of Mental Health Nursing, 12(1), 64–73.
5.
CrillyJ.ChaboyerW.CreedyD. (2004). Violence towards emergency department nurses by patients. Accident and Emergency Nursing, 12(2), 67–73.
DrummondD. J.SparrL. F.GordonG. H. (1989). Hospital violence reduction among high risk patients. JAMA, 261(17), 2531–2534.
8.
EricksonL.Williams-EvansA. (2000). Attitudes of emergency nurses regarding patient assaults. Journal of Emergency Nursing, 26(3), 210–215.
9.
FernandesC. M.BouthilletteF.RaboudJ. M.BullockL.MooreC. F.ChristensonJ. M. (1999). Violence in the emergency department: A survey of health care workers. Canadian Medical Association Journal, 16(10), 1245–1248.
10.
LinakerO. M.Busch-IversenH. (1995). Predictors of imminent violence in psychiatric inpatients. Acta Psychiatrica Scandinavica, 92(4), 250–254.
11.
LynehamJ. (2000). Violence in New South Wales emergency departments. Australian Journal of Advanced Nursing. 18(2), 8–17.
12.
McNielD. E.BinderR. L. (1995). Correlates of accuracy in the assessment of psychiatric inpatients' risk of violence. American Journal of Psychiatry, 152(6), 901–906.
13.
NeedhamI.AbderhaldenC.MeerR.DassenT.HaugH. J.HalfensR. J. (2004). The effectiveness of two interventions in the management of patient violence in acute mental inpatient settings: Report on a pilot study. Journal of Psychiatric and Mental Health Nursing, 11(5), 595–601.
14.
O'ConnellB.YoungJ.BrooksJ.HutchingsJ.LofthouseJ. (2000). Nurses' perceptions of the nature and frequency of aggression in general ward settings and high dependency areas. Journal of Clinical Nursing, 9(4), 602–610.
15.
OlecknoW. A. (2002). Essential epidemiology: Principles and applications. Long Grove, IL: Waveland Press.
16.
OreT. (2002). Workplace assault management training: An outcome evaluation. Journal of Healthcare Protection Management, 18(2), 61–93.
17.
RankinsR. C.HendeyG. W. (1999). Effect of a security system on violent incidents and hidden weapons in the emergency department. Annals of Emergency Medicine, 33(6), 676–679.
18.
RipponT. J. (2000). Aggression and violence in health care professions. Journal of Advanced Nursing, 31(2), 452–460.
19.
SchniedenV.Marren-BellU. (1995). Violence in the accident and emergency department. Accident and Emergency Nursing, 3(2), 74–78.
20.
U.S. Department of Justice. (2001). Violence in the workplace, 1993–1999. In Bureau of Justice statistics special report: National crime victimization survey. Retrieved July 25, 2005, from www.ojp.usdoj.gov/bjs/pub/pdf/vw99.pdf.
