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New aggression tool predicted violent patients in medical and surgical wards
Date:10/19/2011

of the violent incidents involved patients aged over 70, despite the fact that they only made up 40 per cent of the patients studied. Males, who made up 48 per cent of the patients studied were almost twice as likely to become violent as females (64 per cent versus 34 per cent).

The researchers quantified the ability of the ABRAT to predict violence in the medical and surgical settings by using the predictive value, where 100 per cent represents a perfect prediction.

  • The negative predictive value of an ABRAT score of zero - the proportion of subjects with negative test results who were correctly classified to represent a low risk of violence was greater than 99 per cent.

  • The positive predictive value of an ABRAT score of two or more - the proportion of subjects with positive test results who were correctly classified to represent a high risk of violence - was 41 per cent.

  • The five most common predictors of violence were: confusion/cognitive impairment, anxiety, agitation, shouting/demanding and a history of physical aggression.

    The ABRAT included a number of items from the M55 tool, previously used in general acute care. It also drew on the STAMP concept, published in the Journal of Advanced Nursing in 2007, which covers staring and eye contact, tone and volume of voice, anxiety, mumbling and pacing.

    Nurses who had undergone a training course in use of the tool collected the data from patients admitted to six different medical-surgical units.

    "The results from this study indicate that the ten-item ABRAT could be useful in identifying potentially violent patients in medical-surgical units, with acceptable accuracy and agreement between users" says Professor Kim.

    "Further studies are now needed to see whether the use of the ABRAT can actually reduce violence in clinical settings."


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  • Contact: Annette Whibley
    annette.wizard@gmail.com
    Wiley-Blackwell
    Source:Eurekalert

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