Clinical Practice Guideline: Aggression Assessment-Clinical Practice Guideline: Aggression Assessment

Clinical Practice Guideline: Aggression Assessment

Pdf Summary

The "Clinical Practice Guideline: Aggression Assessment" from the Emergency Nurses Association (ENA) addresses the significance of aggression and violence in healthcare settings, particularly in emergency departments (EDs). It identifies the urgent need for implementation of effective assessment tools to predict and mitigate patient aggression and violence, thereby enhancing workplace safety for healthcare professionals. Workplace violence in healthcare settings is notably higher compared to other industries, with a large number of incidents occurring in EDs. Underreporting and cultural norms that accept verbal and physical abuse as part of the healthcare environment exacerbate the issue.<br /><br />The guideline outlines various aggression/violence assessment tools, originally developed for adult inpatient psychiatric settings, to evaluate their efficacy in the ED context. A comprehensive literature review was conducted based on articles from December 1980 to July 2023. Among the 23 tools reviewed, the Brøset Violence Checklist (BVC) showed moderate evidence of efficacy in predicting aggressive or violent events in the ED when used with adult patients. The Aggressive Behavior Risk Assessment Tool (ABRAT) and Dynamic Appraisal of Situational Aggression (DASA-IV) are noted as having weak evidence of effectiveness in adult ED settings. For pediatric populations, tools like the Brief Rating of Aggression by Children and Adolescents (BRACHA) showed insufficient evidence for reliable use in predicting violence.<br /><br />The guideline emphasizes a critical need for additional research to develop and validate high-quality, reliable aggression assessment tools applicable in ED settings across all age groups. It advises the use of evidence-based screening tools tailored for the ED to proactively manage and reduce aggression, ultimately protecting healthcare workers and patients from potential harm.

Keywords

aggression assessment

violence in healthcare

emergency departments

workplace safety

assessment tools

Brøset Violence Checklist

Aggressive Behavior Risk Assessment Tool

Dynamic Appraisal of Situational Aggression

pediatric aggression tools

healthcare worker protection