ABSTRACT
This study examined the use and effectiveness of the Alert assessment form. The form is part of the Alert system, used by one large acute care hospital to identify patients with a propensity for violence. All reported incidents of patient violence from August 1, 2003, through December 31, 2004, were included in patient charts. One hundred seventeen violent patient charts were reviewed and compared with 161 non-violent patient charts, randomly chosen from the same time period. Overall use of the Alert assessment form for violent and non-violent patients was 75.7% and 35.4%, respectively. The assessment form was found to have moderate sensitivity (71%) and high specificity (94%). It is reasonably effective in identifying potentially violent or aggressive patients when it is used according to protocol. Efforts to improve the tool are warranted, as is evaluation of its benefit in settings with low prevalence of violence. Also, greater effort must be taken to prevent violence once an aggressive patient has been identified.
Subject(s)
Inpatients , Nursing Assessment/methods , Risk Assessment/methods , Violence/prevention & control , Acute Disease , Attitude of Health Personnel , British Columbia/epidemiology , Case-Control Studies , Focus Groups , Health Services Needs and Demand , Humans , Inpatients/psychology , Inpatients/statistics & numerical data , Likelihood Functions , Nurse's Role , Nursing Assessment/standards , Nursing Evaluation Research , Nursing Methodology Research , Occupational Health Nursing/organization & administration , Personnel, Hospital/psychology , Predictive Value of Tests , Prevalence , Risk Assessment/standards , Risk Management , Sensitivity and Specificity , Violence/psychology , Violence/statistics & numerical dataABSTRACT
In British Columbia (BC), Canada, a partnership of researchers, healthcare employers, and healthcare unions reduced high injury rates through examining determinants of healthy workplaces and designing, implementing, and evaluating interventions. Over 51 million dollars (Canadian) was saved from the BC healthcare budget over two years, largely attributable to the collaborative effort. Challenges and rewards of the process were determined from interviews and workshops with researchers and community stakeholders, and by obtaining direct input to this report. Challenges included maintaining communication and trust between partners, preserving partnerships during restructuring and labor disputes, and maintaining involvement and support of front-line workers and senior management. As all partners recognized the importance of the research agenda, the stakeholders remained committed to working through the challenges, and have consequently achieved considerable success.
