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Risk factors for violence: an audit on the effect of a tutorial on risk assessment

Published online by Cambridge University Press:  13 June 2014

Frederick Sundrum
Affiliation:
Department of Psychiatry, Waterford Regional Hospital, Dunmore Road, Waterford, Ireland
Stephen Browne
Affiliation:
Department of Psychiatry, Waterford Regional Hospital, Dunmore Road, Waterford, Ireland

Abstract

Objectives: To evaluate the effect of a risk assessment tutorial on the adequacy of case note documentation in a general adult psychiatry setting.

Methods: A comparison of case note documentation of risk factors for violence prior to and subsequent to a risk assessment tutorial.

Results: Prior to the tutorial there were very low rates of documentation of risk of violence. Subsequent to the tutorial, statistically significant improvements in documentation occurred in approximately one third of the items being assessed. Significant improvements occurred in the following; recording a collateral history (from 18%-36%) and previous history of deliberate self harm (from 24%-50%), noting emotions related to violence in the mental state examination (from 2%-24%) and documenting a risk management plan (from 2%-28%). However, levels of documentation remained overall sub-optimal.

Conclusions: Some improvement in case note documentation can result from providing tutorials in risk assessment. However, the ideal format for teaching risk assessment needs to ascertained.

Type
Audit
Copyright
Copyright © Cambridge University Press 2004

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References

1.Lion, JR, Snyder, W, Merrill, GL. Underreporting of assaults on staff in a state hospital. Hosp Comm Psych 1981; 32: 487498.Google ScholarPubMed
2.Kay, SR, Wolkenfield, F, Murrill, LM. Profiles of aggression among psychiatric patients. J Nerv Ment Dis 1988; 176: 547557.CrossRefGoogle ScholarPubMed
3.Sanders, J, Milne, S, Brown, P, Bell, AJ. Assessment of aggression in psychiatric admissions: semi-structured interview and case note survey. BMJ 2000; 320: 1112.CrossRefGoogle Scholar
4.Vinestock, M. Risk assessment; a word to the wise? Adv Psych Treat 1996; 2: 310.CrossRefGoogle Scholar
5.Royal College of Psychiatrists. Assessment and clinical management of risk of harm to other people. Council Report CR53. London: Royal College of Psychiatrists, 1996Google Scholar
6.Campbell, M, Chaplin, R. Improving the assessment of risk of violence: a clinical audit of case note documentation. Psych Bull 2001; 25: 250252.CrossRefGoogle Scholar