Reducing inpatient aggression: does paying attention pay off?
OBJECTIVE
Inpatient aggression is poorly documented in official records. Video technology can improve detection, but is labor-intensive and costly. We examined the effectiveness of interventions to improve reporting on a secure inpatient research unit equipped with audio/video surveillance.


METHODS
Systematic review of all video recorded during a six-week period in 2000 revealed that official documentation omitted 16/71 aggressive incidents (23%). Subsequent interventions to improve reporting involved therapy aides, whose jobs entail continuous direct contact with patients. We reviewed the corresponding period in 2005 to investigate changes in aggression and reporting.


RESULTS
Although the number of aggressive incidents did not change significantly, reporting improved: 59/62 (95%) events detected in 2005 had been reported. Physical aggression decreased and verbal aggression increased.


CONCLUSIONS
Improved reporting may have the unanticipated benefit of reducing physical aggression, perhaps by fostering recognition of and intervention in events that might otherwise escalate into more serious aggression.
Nolan
Karen A
KA
Nathan S Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA. nolan@nki.rfmh.org
Citrome
Leslie
L
D000328:Adult; D000374:Aggression / Q000523:psychology*; D002675:Child, Preschool; D003617:Dangerous Behavior; D005260:Female; D006757:Hospital Units / Q000592:standards / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D008297:Male; D011566:Psychiatric Aides / Q000458:organization & administration; D011618:Psychotic Disorders / Q000523:psychology*; D012308:Risk Management / Q000592:standards / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D014705:Verbal Behavior / Q000145:classification; D014741:Video Recording / Q000379:methods; D014754:Violence / Q000517:prevention & control* / Q000706:statistics & numerical data