Purpose The purpose of this paper is to undertake a systematic literature review to appraise the current evidence relating to the factors associated with violence and aggression in adult psychiatric hospital inpatient settings. Design/methodology/approach A systematic search of following four databases was conducted: Scopus, PsychINFO Medline, CIHAHL and PsychArticle. Following the application of the inclusion criteria, ten papers were extracted and included in the review. A quality appraisal tool, Mixed Methods Appraisal Tool (MMAT) version 2011 (Pluye et al., 2011), was employed for the appraisal of the qualitative and quantitative studies. MMAT has been designed for systematic literature reviews that include qualitative, quantitative and mixed methods studies. Of these, eight were of quantitative methodology and two were of qualitative studies. Findings These ten papers provide an insight into factors associated with violence and aggression towards nursing staff. Three main themes were identified: the environment, attitudes/interaction of staff, and the patient’s mental illness. The themes were important factors in the causes of violence but were interlinked highlighting the complex nature of violence towards nursing staff. The findings support the need for training for nursing staff and the development of ongoing support and for organisations to consider both the environment and the restrictive procedures to help reduce violence and aggression towards nursing staff. Practical implications The paper concludes by outlining the importance of considering the three main themes for clinical practice, training and development of secure services. Originality/value This paper gives insight into the factors associated with patient violence and aggression towards nursing staff in a secure setting.

Objective: To review the development of a psychiatric documentation suite and associated quality improvement processes, comparing suites historically with changes in service delivery and review. Conclusions: Changes to service delivery principles and frameworks have influenced trends to more comprehensive and modular documentation forms. Documentation of quality improvement processes will help ensure that psychiatry-specific needs for information are met during the transition to a more integrated health system and associated electronic records.

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Objective: To describe the development and implementation of a typed ‘continuous’ clinical summary, with a longitudinal formulation and modular episode-based summaries. Methods: Outline of rationale for this form of summary and the implementation process. Results: Despite identified technical and training difficulties, over 3000 clinical assessment summary documents have been created with successful implementation across a mental health service. Conclusions: A typed continuous summary offers many advantages over a traditional discharge summary and can be implemented in routine clinical practice.

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