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Predicting Inpatient Aggression Using the InterRAI Risk of Harm to Others Clinical Assessment Protocol

A Tool for Risk Assessment and Care Planning

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Abstract

This study examined the ability of a risk assessment algorithm, the Risk of Harm to Others Clinical Assessment Protocol (RHO CAP) to predict inpatient aggression within a mental health and addictions treatment facility in Ontario, Canada. Anonymized patient records were retrospectively reviewed from April 1, 2004 to July 31, 2009 (N = 6,425). Survival analysis using Cox’s regression was used to predict time to inpatient aggression using the RHO CAP. Approximately 10% of inpatients were at moderate risk of harm to others, and 2% were considered high risk. The pattern of survival curves revealed that within the first month of admission, approximately 10% of inpatients at high risk of harm to others displayed physical aggression. Patients at high risk were also two times more likely to display physical aggression. Clinical teams can use the RHO CAP to implement preventive safety measures, reduce the incidence of inpatient aggression and improve quality of care.

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Acknowledgements

The authors gratefully acknowledge the helpful comments on a preliminary draft of this manuscript from AC and CW.

Conflicts of interest

None for any author.

Author information

Authors and Affiliations

  1. School of Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada

    Eva Neufeld MA & John P. Hirdes PhD

  2. Homewood Research Institute, Guelph, ON, Canada

    Christopher M. Perlman PhD

  3. Michael G. DeGroote School of Medicine, McMaster University, Waterloo Regional Campus, Kitchener, ON, Canada

    Christopher M. Perlman PhD

Authors
  1. Eva Neufeld MA
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  2. Christopher M. Perlman PhD
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  3. John P. Hirdes PhD
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Corresponding author

Correspondence to Eva Neufeld MA.

Additional information

Results from this manuscript were presented at the annual meeting of the International Network for Excellence in Mental Health (iNEMH), in Reykjavik, Iceland: October 12–18, 2009.

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Neufeld, E., Perlman, C.M. & Hirdes, J.P. Predicting Inpatient Aggression Using the InterRAI Risk of Harm to Others Clinical Assessment Protocol. J Behav Health Serv Res 39, 472–480 (2012). https://doi.org/10.1007/s11414-011-9271-x

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  • DOI: https://doi.org/10.1007/s11414-011-9271-x

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