Abstract
Objective
Inpatient aggression is poorly documented in official records. Video technology can improve detection, but is labor-intensive and costly. We examined the effectiveness of interventions to improve reporting on a secure inpatient research unit equipped with audio/video surveillance.
Method
Systematic review of all video recorded during a six-week period in 2000 revealed that official documentation omitted 16/71 aggressive incidents (23%). Subsequent interventions to improve reporting involved therapy aides, whose jobs entail continuous direct contact with patients. We reviewed the corresponding period in 2005 to investigate changes in aggression and reporting.
Results
Although the number of aggressive incidents did not change significantly, reporting improved: 59/62 (95%) events detected in 2005 had been reported. Physical aggression decreased and verbal aggression increased.
Conclusions
Improved reporting may have the unanticipated benefit of reducing physical aggression, perhaps by fostering recognition of and intervention in events that might otherwise escalate into more serious aggression.
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References
Ito H, Eisen SV, Sederer LI, et al.: Factors affecting psychiatric nurses’ intention to leave their current job. Psychiatric Services 52:232–234, 2001
Lanza ML: The reactions of nursing staff to physical assault by a patient. Hospital and Community Psychiatry 34:44–47, 1983
Whittington R, Wykes T: Staff strain and social support in a psychiatric hospital following assault by a patient. Journal of Advanced Nursing 17:480–486, 1992
US General Accounting Office: Mental health: Improper restraint or seclusion use places people at risk. GAO/HEHS-99-176, 1–35. United States General Accounting Offices, Health Education and Human Services Division, Washington, DC, 1999 (Report)
Lion JR, Synder W, Merrill GL: Underreporting of assaults on staff in a state hospital. Hospital and Community Psychiatry 32:497–498, 1981
Convit A, Isay D, Gadioma R, et al.: Underreporting of physical assaults in schizophrenic inpatients. Journal of Nervous and Mental Disease 176:507–509, 1988
Crowner ML, Peric G, Stepcic F, et al.: A comparison of video cameras and official incident reports in detecting inpatient assaults. Hospital and Community Psychiatry 45:1144–1145, 1994
Crowner ML, Douyon R, Convit A, et al.: Videotape recording of assaults on a state hospital inpatient ward. Journal of Neuropsychiatry and Clinical Neurosciences 3:s9–s14, 1991
Nolan KA, Volavka J: Video recording in the assessment of violent incidents in psychiatric hospitals. Journal of Psychiatric Practice 12:58–63, 2006
Nolan KA, Volavka J, Czobor P, et al.: Aggression and psychopathology in treatment-resistant inpatients with schizophrenia and schizoaffective disorder. Journal of Psychiatric Research 39:109–115, 2005
Nolan KA, Czobor P, Roy BB, et al.: Characteristics of assaultive behavior in psychiatric inpatients. Psychiatric Services 54:1012–1016, 2003
Krakowski MI, Czobor P, Citrome LL, et al.: Atypical antipsychotic agents in the treatment of violent schizophrenic and schizoaffective patients. Archives of General Psychiatry 63:622–629, 2006
Citrome L, Shope CB, Nolan KA, Czobor P, Volavka J: Risperidone alone versus risperidone plus valproate in the treatment of patients with schizophrenia and hostility. International Clinical Psychopharmacology 22:356–362, 2007
Tuninger E, Levander S, Bernce R, et al.: Criminality and aggression among psychotic in-patients: frequency and clinical correlates. Acta Psychiatrica Scandinavica 103:294–300, 2001
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Nolan, K.A., Citrome, L. Reducing Inpatient Aggression: Does Paying Attention Pay Off?. Psychiatr Q 79, 91–95 (2008). https://doi.org/10.1007/s11126-007-9058-7
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DOI: https://doi.org/10.1007/s11126-007-9058-7