OBJECTIVE: This study examined whether staff members' use of
interventions for preventing patients' aggression reduced the number of
incidents of aggression on a closed acute admissions ward of a psychiatric
hospital in the Netherlands. METHODS: The number and severity of incidents
of aggression on three closed wards were measured using the Dutch version
of the Staff Observation Aggression Scale (SOAS). Measurements were made
for three months before and after staff implemented interventions for
preventing aggression on one of the wards. Interventions included a
protocol for talking to patients who exhibited aggressive behavior,
discussing treatment goals with the patient shortly after admission,
explaining why the ward's door was locked and the exit rules, providing a
schedule of staff meetings to explain staff members' absence from the ward,
and clarifying the procedure for making an appointment with the
psychiatrists. RESULTS: The frequency of aggressive incidents was reduced
on all three wards, with no significant difference between the ward where
the interventions were implemented and the two control wards. A marginally
significant difference in the severity of aggressive incidents was found
between experimental and control wards after the introduction of the
preventive measures, with incidents in the experimental ward tending to be
less severe. CONCLUSIONS: This study failed to find a robust effect of
specific intervention measures on aggressive incidents. However, it did
find evidence suggesting that standardized reporting by staff of aggressive
incidents on closed psychiatric wards may in itself result in
straightforward reduction of violent incidents.
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