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Broset Violence Checklist
9
Broset Violence Checklist (BVC) for
Violence Risk Assessment in Psychiatric Hospital
Hyang Ko Tuesday, July 15, 2014
Azusa Pacific University
Background
What is it and how does it work?
- Violence is common on acute psychiatric hospital
- Career prevalence rates of being assaulted approximating 100% for mental healthcare staff during their psychiatric experiences
- Patient violence is related with use of coercive measures (seclusion, restraint)
- Violence destroys therapeutic climate, upset other pts, demoralize staff and sometimes results in fatal damage
- The fear of violence can affect quality of Care
- Lack of research on possible contribution of a structure violence risk assessment to the reduction of aggression in psychiatric hospital
Broset Violence Checklist
– A short term (24h) violence
risk assessment tool.
– Assessment is made
three times daily by
an assigned nurse
(once on each shift).
– Six patient behaviors are
assessed and rated
as present or not present.
Is the Broset Violence checklist effective to decrease violence incidence rate in psychiatric hospital?
Risk levels (sum)
0 = low risk
1-2 = medium risk
>2 = high risk
The highest score
during the past 24 hrs
represents the risk level.
Prediction capacity
Sensitivity: 64 %
(true positive rate)
Specificity: 92 %
(true negative rate)
Kappa: 0.44
Research Summary
What is the point?
Conclusion
References
Abderhalden, C., Needham, I., Dassen, T., Halfens, R., Haug, H. J., & Fischer, J. E. (2008). Structured risk assessment and violence in acute psychiatric wards: randomised controlled trial. The British Journal of Psychiatry, 193(1), 44-50.
Almvik, R., Woods, P., & Rasmussen, K. (2007). Assessing risk for imminent violence in the elderly: the Brøset Violence Checklist. International journal of geriatric psychiatry, 22(9), 862-867.
Almvik, R., Woods, P., & Rasmussen, K. (2000). The Brøset Violence Checklist sensitivity, specificity, and interrater reliability.Journal of interpersonal violence, 15(12), 1284-1296.
Clarke, D. E., BROWN, A. M., & Griffith, P. (2010). The Brøset Violence Checklist: Clinical utility in a secure psychiatric intensive care setting. Journal of psychiatric and mental health nursing, 17(7), 614-620.
Van de Sande, R., Nijman, H. L. I., Noorthoorn, E. O., Wierdsma, A. I., Hellendoorn, E., Van DerStaak, C., &Mulder, C. L. (2011). Aggression and seclusion on acute psychiatric wards: effect of short-term risk assessment. The British Journal of Psychiatry, 199(6), 473-478.
Early preventive interventions.
- The next shift can expect on-going
preventive interventions for patients with
BVC sums of >2.
- Formulating multiple approach with BVC
of >2 to increase overall safety
- Reduction incident rate and coercive measures
- Prediction of violence risk in mentally ill patients and geriatric and elderly with dementia population
- The BVC is proved to be easy, quick to use and cost-effective.
- Therefore, the BVC is a great tool to assess violence risk in the psychiatric hospital.