Violent Event Severity Tool for Reporting Violent Incidents

Kim, Son Chae; Kim, Youngho Paul

doi:10.1097/nna.0000000000001361

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…This violent event rate is consistent with previous studies that reported rates of 1.2% or 1.7%. 8 , 27 These low percentages of ED patients exhibiting violent behaviors appear to conflict with the high percentages of ED staff experiencing violence. However, the percentages are based on two different units of measure: the former is based on every 100 ED patients, whereas the latter is based on every 100 ED staff.…”

Section: Discussionmentioning

confidence: 99%

“…The VEST was used to collect data on various types and severities of violence. 8 The VEST provides operational definitions of six violence types, including physical assault, physical threat, verbal threat, verbal abuse, sexual harassment, and written threat. Each violence type includes severity criteria ranging from grade 1 (mild) to grade 4 (life threatening) to objectively capture the events.…”

Section: Methodsmentioning

confidence: 99%

“…The Violent Event Severity Tool (VEST) was developed to collect various violence types and severities, which would facilitate reliable assessment of violence prevention strategies over time. 8 In addition, a validated violence risk screening tool would be useful in implementing patient violence prevention programs. The Aggressive Behavior Risk Assessment Tool for EDs (ABRAT‐ED) has been developed and previously validated for assessing violence risk during ED triage.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Kim,

Kaiser,

Hosford

et al. 2024

JACEP Open

Self Cite

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The Impact of Patient Assaults and Aggressive Behaviors on Nursing Personnel's Stress, Well-being, and Intention to Leave Post–COVID-19 Pandemic

Chipps,

Weaver,

Wood

et al. 2024

JONA: The Journal of Nursing Administration

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AIM To describe and compare the prevalence of assaults and aggressive patient behavior among frontline staff in behavioral health (BH), medical-surgical (MS), and emergency department (ED) settings and examine the impact on staff health, work stress, work engagement, and intent to leave their position. BACKGROUND Patient verbal and physical assaults have significant staff consequences, including decreased work productivity, increased burnout, job dissatisfaction, absenteeism, turnover, and intentions to leave. METHODS Using a descriptive cross-sectional design, data were collected from a sample of 432 frontline staff working in ED, BH, and MS settings across 3 healthcare systems. RESULTS The majority of frontline staff (74%) reported experiencing verbal aggression often/frequently, significantly impacting their mental health, work engagement, stress levels, and intent to leave. All 3 specialty groups reported a significant increase in verbal/psychological assaults and physical assaults since the pandemic's onset. CONCLUSION The COVID-19 pandemic had a significant impact on assaultive/aggressive behaviors. Nurse leaders must strategize on methods to decrease the normalization of violence against healthcare workers and support research aimed at evidence-based interventions to reduce such incidences of violence and ensure the well-being of healthcare workers.

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Aggressive Behaviour Risk Assessment Tool for Hospitalised Patients in Non‐Psychiatric Inpatient Units

Kim,

Vejnovich,

Hall

et al. 2024

Journal of Advanced Nursing

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AimTo refine and validate an electronic version of the Aggressive Behaviour Risk Assessment Tool (ABRAT) and determine the sensitivity and specificity for identifying potentially violent patients in non‐psychiatric inpatient units.DesignA prospective cohort study design was used.MethodsAll patients admitted or transferred to three inpatient units of an acute care hospital in Nebraska, USA, from 7 February to 9 April 2023, were included. The 10‐item ABRAT assessments were performed daily for the first 3 days of admission. The violent events were collected until discharge in three categories: Physical aggression towards others, physical aggression towards property and verbal intimidation/threat towards others. Kendall's tau tests and a multivariate logistic regression procedure were performed to select a parsimonious set of items that best predict violent events.ResultsOf 1179 patients, 69 had ≥1 violent event (5.9%). The revised six‐item tool with item weighting was named ABRAT for Hospitalised Patients (ABRAT‐H). The area under the curve from the Receiver Operating Characteristics analysis was 0.82. The sensitivity and specificity at a cutoff score of two were 68.1% and 85.2%, respectively. As ABRAT‐H scores increased, the percentage of violent patients also increased and for patients with scores ≥5, 55.2% became violent.ConclusionABRAT‐H appears to be useful for identifying potentially violent patients in non‐psychiatric inpatient units with satisfactory sensitivity and specificity.Implications for Patient CareThe availability of ABRAT‐H may help provide focused preventive measures that target patients at high risk for violence and reduce violent events.ImpactA majority of the nursing workforce is employed in acute care hospital setting, and the availability of ABRAT‐H can further enhance the culture of a safe work environment and have positive impacts not only on the nurses' physical and mental health but also on the quality of patient care.Reporting MethodWe have adhered to relevant STROBE guidelines for reporting observational studies.Patient or Public ContributionNo Patient or Public Contribution.

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Violent Event Severity Tool for Reporting Violent Incidents

Cited by 3 publications

References 16 publications

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

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

The Impact of Patient Assaults and Aggressive Behaviors on Nursing Personnel's Stress, Well-being, and Intention to Leave Post–COVID-19 Pandemic

Aggressive Behaviour Risk Assessment Tool for Hospitalised Patients in Non‐Psychiatric Inpatient Units

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