Abstract
Psychiatric patient assaults on staff are a serious and continuing problem in health care settings. Over thirty years of empirical research have documented the characteristics of both patient assailants and staff victims. Notably absent from this literature have been similar empirical studies on the nature of patient precipitants to these assaults. This paper reviewed empirical studies of patient assault precipitants from 1990–2003. Six studies from three countries were reviewed. Common precipitants included staff restrictions on patient behaviors, denial of services, excessive sensory overload, and provocation by others. The clinical, methodological, and risk management implications are examined.
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References
American Psychiatric Association. Clinician Safety. Task Force Report {#}33. Washington, DC, American Psychiatric Press, 1992.
Caldwell ME: The incidence of PTSD among staff victims of patient violence. Hospital and Community Psychiatry 43:438–439, 1992.
Occupational Safety and Health Administration: Guidelines for Preventing Workplace Violence in Healthcare and Social Services Workers. Publication {#}3148. Washington, DC, United States Department of Health and Human Services, 1996.
Blair DT: Assaultive behavior: Does provocation begin in the front office? Journal of Psychosocial Nursing 29:21–26, 1991.
Busch AB, Shore MF: Seclusion and restraint: A review of the literature. Harvard Review of Psychiatry 8:261–270, 2000.
Davis S: Violence in psychiatric patients: A review. Hospital and Community Psychiatry 42:585–590, 1991.
Flannery RB Jr: Characteristics of assaultive psychiatric inpatients: Updated review of findings, 1995–2000. American Journal of Alzheimer's Disease and Other Dementias 16:153–156, 2001.
Nestor PG: Mental disorder and violence: Personality dimensions and clinical features. American Journal of Psychiatry 159:1973–1978, 2002.
Flannery RB Jr: 2003 Characteristics of staff victims of psychiatric patient assaults: Updated review of findings, 1995–2001. American Journal of Alzheimer's Disease and Other Dementias 19:35–38, 2004.
Aquilina C: Violence by psychiatric patients. Medicine, Science, and the Law 31:306–312, 1991.
Sheridan M, Henrion R, Robinson L, et al: Precipitants of violence in a psychiatric inpatient setting. Hospital and Community Psychiatry 41:776–780, 1990.
Morrison EF: A coercive interactional style as an antecedent to aggression in psychiatric patients. Research in Nursing Health 15:421–431, 1992.
Powell G, Caan W, Crowe M: What events precede violent incidents in psychiatric hospitals? British Journal of Psychiatry 165:107–112, 1994.
Cheung P, Schweitzer I, Tuckwell V, et al: A prospective study of assaults on staff by psychiatric inpatients. Medicine, Science, and the Law 37:46–52, 1997.
Shepherd J, Lavender T: Putting aggression into context: An investigation into contextual factors influencing the rate of aggression incidents in a psychiatric hospital. Journal of Mental Health 8:159–170, 1999.
Flannery RB Jr, Hanson MA, Walker AP: Precipitants of patient psychiatric assaults on staff: Preliminary empirical inquiry of the Assaulted Staff Action Program (ASAP). International Journal of Emergency Mental Health 5:141–146, 2003.
Flannery RB Jr: Violence in the Workplace. New York, NY, Crossroad Press, 1995.
Tardiff K: Concise Guide to Assessment and Management of Violent Patients. Washington, DC, American Psychiatric Press, 1996.
Flannery RB Jr: The Assaulted Staff Action Program (ASAP): Coping with the Psychological Aftermath of Violence. Ellicott City, MD, 1998.
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Flannery, R.B. Precipitants to psychiatric patient assaults on staff: review of empirical findings, 1990–2003, and risk management implications. Psychiatr Q 76, 317–326 (2005). https://doi.org/10.1007/s11126-005-4965-y
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DOI: https://doi.org/10.1007/s11126-005-4965-y