Aggressive Behaviour Risk Assessment Tool for Hospitalised Patients in Non-Psychiatric Inpatient Units.

AIM

To refine and validate an electronic version of the Aggressive Behaviour Risk Assessment Tool (ABRAT) and determine the sensitivity and specificity for identifying potentially violent patients in non-psychiatric inpatient units.

DESIGN

A prospective cohort study design was used.

METHODS

All patients admitted or transferred to three inpatient units of an acute care hospital in Nebraska, USA, from 7 February to 9 April 2023, were included. The 10-item ABRAT assessments were performed daily for the first 3 days of admission. The violent events were collected until discharge in three categories: Physical aggression towards others, physical aggression towards property and verbal intimidation/threat towards others. Kendall's tau tests and a multivariate logistic regression procedure were performed to select a parsimonious set of items that best predict violent events.

RESULTS

Of 1179 patients, 69 had ≥1 violent event (5.9%). The revised six-item tool with item weighting was named ABRAT for Hospitalised Patients (ABRAT-H). The area under the curve from the Receiver Operating Characteristics analysis was 0.82. The sensitivity and specificity at a cutoff score of two were 68.1% and 85.2%, respectively. As ABRAT-H scores increased, the percentage of violent patients also increased and for patients with scores ≥5, 55.2% became violent.

CONCLUSION

ABRAT-H appears to be useful for identifying potentially violent patients in non-psychiatric inpatient units with satisfactory sensitivity and specificity.

IMPLICATIONS FOR PATIENT CARE

The availability of ABRAT-H may help provide focused preventive measures that target patients at high risk for violence and reduce violent events.

IMPACT

A majority of the nursing workforce is employed in acute care hospital setting, and the availability of ABRAT-H can further enhance the culture of a safe work environment and have positive impacts not only on the nurses' physical and mental health but also on the quality of patient care.

REPORTING METHOD

We have adhered to relevant STROBE guidelines for reporting observational studies.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.