Implementing violence and incident reporting measures on a forensic mental health unit

Abstract

The assessment of risk and prediction of violence in mental health units can play a large role in creating a safer environment for both the staff and the patients. Nurses in forensic units are in a unique position in regards to assessment of violence as they spend a great deal of time with the patients. Nurses on a forensic mental health unit scored the Brøset Violence Checklist (BVC) twice daily for 12 weeks for all patients either resident on or admitted to the unit (N = 46). The Staff Observation Aggression Scale-Revised (SOAS-R) was used to report any adverse incidents (N = 51). Data were examined at the both the item and scale level. Main results showed the area under the curve values of the BVC score, slide rule, and the sum of BVC and slide rule score in turn demonstrated strong predictive accuracy for inpatient aggression (0.68–0.73). Through logistic regression analyses the BVC uniquely predicted inpatient aggression but adding the slide rule did not improve prediction. Predictive accuracy was found across three diagnostic groups – dementia, psychosis and substance use disorders. These results provide further support on the predictive accuracy of the BVC for short-term violence in forensic mental health settings.