title: Usefulness of Aggressive Behaviour Risk Assessment Tool for prospectively identifying violent patients in medical and surgical units.
abstract: OBJECTIVE
  The aim of this study is to evaluate the usefulness of the Aggressive Behaviour Risk Assessment Tool for prospectively identifying violent patients in medical-surgical units.
  
  
  BACKGROUND
  Although patient violence against nurses is a serious occupational hazard, there is a lack of simple screening tools with acceptable sensitivity and specificity for identifying potentially violent patients in medical-surgical units.
  
  
  METHODS
  A prospective cohort study involving patients admitted to six medical-surgical units at an acute care hospital was conducted from August 2009 to December 2009. Primary nurses completed the 17-item checklist within 24 hours of admission. A second identical checklist was completed by another nurse to assess the inter-rater reliability. Following a violent event or just prior to discharge, the violent event outcome section was completed to collect information about violent event, if any. A multivariate logistic regression model with backward elimination was used to select a set of parsimonious items that best predict violent behaviours.
  
  
  RESULTS
  Fifty-six patients out of 2063 (2·7%) had one or more violent events. A parsimonious set of ten items were selected for the tool. Receiver Operating Characteristics analysis of Aggressive Behaviour Risk Assessment Tool showed that the area under the curve was 0·82 (95% Confidence Interval, 0·75-0·90). The sensitivity and specificity at the cut-off score of 1 were 70·9% and 89·3%, respectively. The Cohen's Kappa for inter-rater reliability was 0·647.
  
  
  CONCLUSIONS
  The Aggressive Risk Assessment Tool is a simple, easy-to-use assessment tool with acceptable inter-rater reliability, sensitivity and specificity that may be useful for prospectively identifying violent patients in medical-surgical units.
authors.affiliation: School of Nursing, Point Loma Nazarene University, San Diego, California, USA. sonkim@pointloma.edu
authors.forename: Son Chae
authors.initials: SC
authors.lastname: Kim
authors.forename: Kristyn
authors.initials: K
authors.lastname: Ideker
authors.forename: Dale
authors.initials: D
authors.lastname: Todicheeney-Mannes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000374:Aggression; D057189:Checklist / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital; D011446:Prospective Studies; D011594:Psychometrics; D018570:Risk Assessment / Q000379:methods; D013223:Statistics as Topic; D014754:Violence / Q000517:prevention & control* / Q000706:statistics & numerical data; D055815:Young Adult