Multisite study of Aggressive Behavior Risk Assessment Tool in emergency departments

Kim, Son Chae; Kaiser, Jennifer; Bulson, Julie; Hosford, Tracy; Nurski, Ashleigh; Sadat, Carol; Kalinowski, Nicole

doi:10.1002/emp2.12693

Cited by 15 publications

(22 citation statements)

References 18 publications

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“…Several tools have been published more recently that are focused on screening for violence in the ED setting. [22][23][24]27,28 However, HCWs in the ED should consider using systematic violence screening tools that encompass their patient population and the type of violent events and situational triggers that occur in their ED setting. Viewing patient-to-staff violence through the SEM framework 29 can contextualize the patient population, types of violent events, antecedents and precedents of violent events, violence, and clinical history typically identified in each unique ED setting.…”

Section: Discussionmentioning

confidence: 99%

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Implementation of an Assault Prevention Quality Improvement Initiative in an Urban Emergency Department

Mallett-Smith

Jadalla

Hardan-Khalil

et al. 2023

Journal of Nursing Care Quality

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Background: Emergency department (ED) health care workers experience high rates of workplace violence (WPV).Local Problem: Patient-to-staff physical assaults at an urban, academic adult ED ranged between 1 and 5 per month, with a rate of 0.265 per 1000 patient visits. Methods: A quality improvement initiative, guided by the Social Ecological Model framework that contextualized WPV in the ED setting, informed the development of a Risk for Violence Screening Tool (RVST) to screen adult patients presenting to the ED. Interventions: Plan-Do-Study-Act cycles were utilized to implement a violence prevention bundle that incorporated the RVST, an alert system, and focused assault reduction strategies. Results: Patient-to-staff physical assaults decreased to a rate of 0.146 per 1000 patient visits. Conclusions: Risk for violence screening, an alert system, and assault prevention strategies provide opportunities for nurse leaders to promote ED workplace safety.

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Section: Discussionmentioning

confidence: 99%

“…Several tools have been published more recently that are focused on screening for violence in the ED setting 22–24,27,28. However, HCWs in the ED should consider using systematic violence screening tools that encompass their patient population and the type of violent events and situational triggers that occur in their ED setting.…”

Section: Discussionmentioning

confidence: 99%

Implementation of an Assault Prevention Quality Improvement Initiative in an Urban Emergency Department

Mallett-Smith

Jadalla

Hardan-Khalil

et al. 2023

Journal of Nursing Care Quality

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“…Incorporating the VEST into EHR could allow the simple and easy collection of WPV regularly as a part of routine nursing assessments. Our previous studies of patient violence in medical-surgical units and emergency departments indicated that the violence occurs in 1% to 3% of the patients 20,21 . For nonviolent patients, the VEST can be completed quickly by responding “no” to the 1st question of whether any violent event has occurred.…”

Section: Discussionmentioning

confidence: 99%

“…Using a validated risk-screening tool may assist staff in identifying patients at high risk for violence and allow the implementation of focused, preemptive violence prevention measures. In our previous studies, Aggressive Behavior Risk Assessment Tool (ABRAT) was effective in identifying potentially violent patients with satisfactory sensitivities and specificities in acute care medical-surgical units and emergency departments 20,21 . Focusing preventive interventions on a small fraction of the patients at high risk of violence could allow better resource utilization than an indiscriminate, universal precaution recommended by the Occupational Safety and Health Administration 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Our previous studies of patient violence in medical-surgical units and emergency departments indicated that the violence occurs in 1% to 3% of the patients. 20,21 For nonviolent patients, the VEST can be completed quickly by responding "no" to the 1st question of whether any violent event has occurred. Therefore, the documentation burden of the VEST would be minimal for nonviolent patients.…”

Section: Discussionmentioning

confidence: 99%

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Violent Event Severity Tool for Reporting Violent Incidents

Kim,

Kim

2023

JONA: The Journal of Nursing Administration

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OBJECTIVES To explore the usefulness of the Violent Event Severity Tool (VEST). BACKGROUND The Joint Commission and many governing bodies require establishing workplace violence prevention programs in hospitals. Inconsistent processes have hampered the efficacy evaluation of such programs for collecting and reporting violence. The VEST was developed as a standardized tool for capturing violence data. METHODS Ninety-six healthcare workers attending the 2022 Magnet® conference completed the survey. The VEST includes 6 types and 4 intensities of violent incidents. RESULTS Most participants reported that the VEST is easy to use (79%), relevant (85%), and useful (85%). Fewer than half were satisfied with their incident report filing processes. Only 38% of participants experiencing grade 1 physical assault filed an incident report, whereas 70% and 100% experiencing grades 3 and 4 physical assaults filed. CONCLUSIONS The VEST appears to be a useful and relevant tool for consistent collection and reporting of various violence types and severities.

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A workplace violence prevention program targeting high‐risk patients in emergency departments

Kim,

Kaiser,

Hosford

et al. 2024

JACEP Open

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ObjectivePatient violence in emergency departments (EDs) may be prevented with proactive mitigation measures targeting potentially violent patients. We aimed to evaluate the effects of two interventions guided by a validated risk‐assessment tool.MethodsA prospective interventional study was conducted among patients ≥10 years who visited two EDs in Michigan, USA, from October 2022 to August 2023. During triage, the ED nurses completed the Aggressive Behavior Risk Assessment Tool for EDs (ABRAT‐ED) to identify high‐risk patients. Following the baseline observational period, interventions were implemented stepwise for the high‐risk patients: phase 1 period with signage posting and phase 2 period with a proactive Behavioral Emergency Response Team (BERT) huddle added to the signage posting. Before ED disposition, any violent events and their severities were documented. The data were retrieved retrospectively after the study was completed.ResultsOf 77,424 evaluable patients, 546 had ≥1 violent event. The violent event rates were 0.93%, 0.68%, and 0.62% for baseline, phase 1, and phase 2, respectively. The relative risk of violent events for phase 1 compared to the baseline was 0.73 (95% confidence interval [CI]: 0.59‒0.90; p = 0.003). The relative risk for phase 2 compared to phase 1 was 0.92 (95% CI: 0.76‒1.12; p = 0.418).ConclusionThe use of signage posting as a persistent visual cue for high‐risk patients identified by ABRAT‐ED appears to be effective in reducing the overall violent event rates. However, adding proactive BERT huddle to signage posting showed no significant reduction in the violent event rates compared to signage posting alone.

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Multisite study of Aggressive Behavior Risk Assessment Tool in emergency departments

Cited by 15 publications

References 18 publications

Implementation of an Assault Prevention Quality Improvement Initiative in an Urban Emergency Department

Implementation of an Assault Prevention Quality Improvement Initiative in an Urban Emergency Department

Violent Event Severity Tool for Reporting Violent Incidents

A workplace violence prevention program targeting high‐risk patients in emergency departments

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