title: Predicting inpatient aggression using the InterRAI risk of harm to others clinical assessment protocol: a tool for risk assessment and care planning.
abstract: This study examined the ability of a risk assessment algorithm, the Risk of Harm to Others Clinical Assessment Protocol (RHO CAP) to predict inpatient aggression within a mental health and addictions treatment facility in Ontario, Canada. Anonymized patient records were retrospectively reviewed from April 1, 2004 to July 31, 2009 (N = 6,425). Survival analysis using Cox's regression was used to predict time to inpatient aggression using the RHO CAP. Approximately 10% of inpatients were at moderate risk of harm to others, and 2% were considered high risk. The pattern of survival curves revealed that within the first month of admission, approximately 10% of inpatients at high risk of harm to others displayed physical aggression. Patients at high risk were also two times more likely to display physical aggression. Clinical teams can use the RHO CAP to implement preventive safety measures, reduce the incidence of inpatient aggression and improve quality of care.
authors.affiliation: School of Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada. elneufel@uwaterloo.ca
authors.forename: Eva
authors.initials: E
authors.lastname: Neufeld
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Perlman
authors.forename: John P
authors.initials: JP
authors.lastname: Hirdes
mesh_terms: D000328:Adult; D017677:Age Distribution; D000374:Aggression / Q000523:psychology*; D002170:Canada; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D010347:Patient Care Planning; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data*; D012307:Risk Factors; D012308:Risk Management; D017678:Sex Distribution; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers; D011795:Surveys and Questionnaires; D016019:Survival Analysis