PS 1997; 48:1177-1180
Copyright © 1997 by American Psychiatric Association
Use of the NOSIE to predict assaults among acute psychiatric patients. Nurses' Observational Scale for Inpatient Evaluation
C Swett and T Mills
New Hampshire Hospital, Concord 03301, USA.
OBJECTIVE: The study evaluated the Nurses' Observational Scale for
Inpatient Evaluation (NOSIE), the Brief Psychiatric Rating Scale (BPRS),
the Mini Mental State Examination (MMSE), and other measures as predictors
of assaults that occurred during psychiatric hospitalization. METHODS: On
admission, the MMSE was administered to 335 acutely ill psychiatric
patients, and diagnostic and demographic data were recorded. Immediately
after admission, patients were rated by nurses using the NOSIE and by
psychologists using the BPRS. Patients who committed assaults during
hospitalization (N = 47) and those who did not were compared, and
relationships between several variables and assaults were evaluated by t
tests, Mann-Whitney U tests, chi square tests, and analyses of variance.
RESULTS: A high score on the irritability factor of the NOSIE and failure
to complete the MMSE correctly predicted the occurrence or nonoccurrence of
assault 81 percent of the time. None of the other variables examined were
significantly related to assaults, including total scores on the BPRS and
MMSE, psychiatric diagnosis, and several demographic variables.
CONCLUSIONS: Scores on a test of distress level shortly after admission and
failure to complete the MMSE on admission can help the clinician predict
who will later engage in an assault.
