Aggressive patient behaviours and unplanned nursing staff leave - is there an association?

Abstract

Mental health nurses are exposed to high levels of aggressive and challenging patient behaviours. This can cause stress and burnout which is associated with poor staff, patient, and organization outcomes, including unplanned nursing staff leave (UNSL). This study explores the correlation between a patient behaviour tool (RAGE), variations of which are frequently used in mental health and psychogeriatric nursing, and the staff outcome of UNSL. The study is reported according to the STROBE Statement for reporting of observational studies. RAGE scores and ward characteristics were recorded weekly for 26weeks on an Australian metropolitan psychogeriatric ward and correlated with UNSL for the same week and the following week (allowing for any 'lag effect' behaviours may have on leave). There was a moderate negative correlation between mean RAGE score and UNSL for the same week (r=-0.34) and no correlation the following week (r=0.08). Similarly, there was low to no correlation between ward characteristics and UNSL. The trends seen in this exploratory study should be further interrogated in adequately powered future studies. UNSL is likely influenced by complex factors including staff experience, coping mechanism, and specific patient behaviours such as physical or verbal aggression and whether the behaviours resulted in injury, which should be included in future studies. The novel strategy of utilizing patient-centred tools to predict staff outcomes is feasible and warrants further exploration.