Predicting inpatient aggression using the InterRAI risk of harm to others clinical assessment protocol: a tool for risk assessment and care planning

TitlePredicting inpatient aggression using the InterRAI risk of harm to others clinical assessment protocol: a tool for risk assessment and care planning
Publication TypeJournal Article
Year of Publication2012
AuthorsNeufeld E., Perlman C.M, Hirdes J.P
JournalJ Behav Health Serv Res
Volume39
Issue4
Pagination472-80
Date PublishedOct
ISBN Number1556-3308 (Electronic)<br/>1094-3412 (Linking)
Accession Number22258559
Keywords*Patient Care Planning, Adult, Age Distribution, Aggression/*psychology, Canada, Female, Humans, Inpatients/*psychology/statistics & numerical data, length of stay, Male, Mental Disorders/complications/*psychology/therapy, Middle Aged, Predictive Value of Tests, Proportional Hazards Models, Psychiatric Status Rating Scales, Reproducibility of Results, Retrospective Studies, Risk Assessment/*statistics & numerical data, Risk Factors, Risk Management, Sex Distribution, Socioeconomic Factors, Substance Abuse Treatment Centers, Surveys and Questionnaires, Survival Analysis
Abstract

This study examined the ability of a risk assessment algorithm, the Risk of Harm to Others Clinical Assessment Protocol (RHO CAP) to predict inpatient aggression within a mental health and addictions treatment facility in Ontario, Canada. Anonymized patient records were retrospectively reviewed from April 1, 2004 to July 31, 2009 (N = 6,425). Survival analysis using Cox's regression was used to predict time to inpatient aggression using the RHO CAP. Approximately 10% of inpatients were at moderate risk of harm to others, and 2% were considered high risk. The pattern of survival curves revealed that within the first month of admission, approximately 10% of inpatients at high risk of harm to others displayed physical aggression. Patients at high risk were also two times more likely to display physical aggression. Clinical teams can use the RHO CAP to implement preventive safety measures, reduce the incidence of inpatient aggression and improve quality of care.

DOI10.1007/s11414-011-9271-x
Link

https://www.ncbi.nlm.nih.gov/pubmed/22258559https://link.springer.com/content/pdf/10.1007%2Fs11414-011-9271-x.pdf