Predicting inpatient violence in acute psychiatric wards using the Brøset-Violence-Checklist: a multicentre prospective cohort study.
The Norwegian Brøset-Violence-Checklist (BVC) is one of the few instruments that is suitable for short-term prediction of violence of psychiatric inpatients by nursing staff in routine care. The instrument assesses the presence or absence of six behaviours or states frequently observed before a violent incident. We conducted a study to elucidate whether the predictive properties of the BVC are retained in other psychiatric settings than the original north-Norwegian validation dataset. During their admission period, 219 consecutive patients admitted to six acute psychiatric wards were assessed as to the risk for attack using a German version of the BVC (BVC-G). Data on preventive measures were concurrently collected. Aggressive incidents were registered using an instrument equivalent to the Staff Observation of Aggression Scale (SOAS-R). Fourteen attacks towards staff were observed with incident severity ranging from 5 to 18 of a possible 22 points. BVC-G sensitivity was 64.3%, the specificity 93.9%, the positive predictive value 11.1%, and the area under the receiver operating characteristic curve 0.88. In some false positive cases intense preventive measures had been implemented. The predictive accuracy of the BVC-G proved consistent with the Norwegian original.
Abderhalden
C
C
Nursing and Social Educatio Research Unit, University Berne Psychiatric Services, Bolligenstrasse, CH-300 Bern 60, Switzerland. abderhalden@puk.unibe.ch
Needham
I
I
Miserez
B
B
Almvik
R
R
Dassen
T
T
Haug
H-J
HJ
Fischer
J E
JE
D015331:Cohort Studies; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000451:nursing / Q000523:psychology; D009664:Norway; D009730:Nursing Assessment / Q000379:methods*; D015403:Nursing Evaluation Research; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011567:Psychiatric Department, Hospital; D011568:Psychiatric Nursing / Q000379:methods*; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D013557:Switzerland; D013997:Time Factors; D014754:Violence / Q000517:prevention & control* / Q000523:psychology