The effectiveness of interventions in the prevention and management of aggressive behaviours in patients admitted to an acute hospital setting.

Abstract

Review Question: This systematic review seeks to establish what is best practice in prevention and management of aggressive behaviours in patients admitted to an acute hospital setting. More specifically, the objectives are to identify; 1) What are the most effective interventions in the prevention of aggressive behaviours in patients admitted to an acute hospital setting? 2) What are the most effective interventions in the management of aggressive behaviours in patients admitted to an acute hospital setting? Inclusion Criteria: Types of participants: This review will consider studies that include adult patients admitted to an acute hospital setting who exhibit aggressive behaviours. Aggressive behaviours will include verbal abuse, non-verbal abuse, violent behaviours and assault. Types of interventions: All studies evaluating the following interventions will be considered for inclusion in the review: Administration of PRN prescribed medications Restraining Clinician behaviours including: - Verbal communication techniques - Use of body language - Prevention and recognition strategies (eg. use of risk assessment tools) - Staff attitudes and skills Environmental controls (eg. minimising light, noise and conversations) Setting of limits for patients to follow Increase in staff numbers Type of outcome (if any): This component of the review will consider studies that include the following outcomes: Aggressive behaviour Staff injuries Patients absconding Stress/anxiety levels among staff Patient injuries Length of hospital stay Early detection of aggressive behaviours