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Evidence-based violence risk assessment in psychiatric inpatient care: an implementation study

Lantta, Tella (2016-11-11)

Evidence-based violence risk assessment in psychiatric inpatient care: an implementation study

Lantta, Tella
(11.11.2016)
Katso/Avaa
Annales D 1255 Lantta DISS.pdf (1.730Mb)
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Annales Universitatis Turkuensis D 1255 Turun yliopisto
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Julkaisun pysyvä osoite on:
https://urn.fi/URN:ISBN:978-951-29-6629-5

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Siirretty Doriasta
Tiivistelmä
The aim of this study was to promote evidence-based violence risk assessment in inpatient psychiatric care. The study was an implementation study with three phases utilizing a mixed-method approach. The Ottawa Model of Research Use was used as a theoretical framework. The setting was three closed adults’ psychiatric wards and two associations for families of mental health patients. The violence risk assessment intervention implemented was the Dynamic Appraisal of Situational Aggression.

First, assessment of key elements for implementation was explored from the perspectives of nursing staff, relatives of mental health patients, and the practice environment. In addition, the intervention was specified. Second, implementation was monitored on the wards: barriers and facilitators for the implementation, knowledge transfer strategies, adaptation and use of the intervention were explored. Third, evaluation of outcomes of the intervention implemented was done from perspectives of nursing staff and mental health inpatients. The feasibility of the intervention was explored.

Assessment of key elements revealed the views of nursing staffs and relatives of mental health patients on the complexity of violent events in psychiatric care and identified common needs for the development of violence prevention and management. Monitoring the implementation yielded knowledge about intervention implementation in the clinical practice setting and its challenges. Evaluation of implementation outcomes revealed mixed perceptions of violence risk assessment intervention and the feasibility criteria set were not fully met.

This dissertation provides new insights which can be utilized when implementing novel methods to prevent and manage patent violence in more user-centered manners. On basis of the study results, patient involvement in short-term risk assessment can be seen as a new, promising working method in psychiatric inpatient care. Thus, to confirm this finding, more research is needed.
 
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