Contemporary management of aggression in an inner city mental health service.
OBJECTIVE
From 2002 to mid 2003, Royal Brisbane and Women's Hospital Mental Health experienced increased patient - staff aggression and staff injury which resulted in staff conflict and recruitment difficulties. Strategies introduced to reduce the frequency and impact of aggression in the mental health service were evaluated.


METHODS
By mid 2003, incident data indicated increasing aggressive incidents. Based on this, an aggression management strategy was developed which included improved staff communication, new acute pharmacological treatment protocols, mandatory staff aggression management training, personal alarms and aggression risk assessment tools.


RESULTS
Following the introduction of the strategy in early 2004, there was a reduction of 40% in aggressive incidents and a 56% reduction in staff injuries in 2005 compared to 2003 levels. A more assertive approach to tranquillisation was not associated with an increased adverse event rate for patients.


CONCLUSIONS
A co-ordinated strategy can contain and reduce aggressive incidents in acute inpatient mental health settings. These strategies are transferable to other health settings including Emergency Departments.
Emmerson
Brett
B
RBWH Mental Health, University of Queensland, Qld, Australia. Brett_Emerson@health.qld.gov.au
Fawcett
Lisa
L
Ward
Warren
W
Catts
Stanley
S
Ng
Agnes
A
Frost
Aaron
A
D000208:Acute Disease; D000374:Aggression / Q000523:psychology*; D001315:Australia / Q000453:epidemiology; D002985:Clinical Protocols / Q000592:standards; D003142:Communication; D003419:Crisis Intervention / Q000379:methods*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007400:Interprofessional Relations; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D008605:Mental Health Services / Q000458:organization & administration* / Q000639:trends; D015995:Prevalence; D011369:Professional-Patient Relations; D012308:Risk Management; D019037:Urban Health Services / Q000458:organization & administration* / Q000639:trends; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data