Triggers, Responses, and Outcomes for Patient Related Violence and/or Aggression Events During Acute Hospitalisation: A Documentary Analysis

ABSTRACT

Aim

To examine triggers, responses, and outcomes for patient-related violence and/or aggression events during acute hospitalisation.

Design

This was a descriptive observational study undertaken at two healthcare organisations.

Methods

Pre-existing data were extracted from organisational incident reports and individual medical records during a retrospective period (1/1/2023 to 30/6/2023) and a prospective period (7/6/2024 to 16/11/2024). Violence and/or aggression events requiring an organisational response that involved patients hospitalised in general ward areas at a metropolitan (Site A) and a regional (Site B) site were included. Data were analysed using descriptive statistics and content analysis.

Results

The sample included 100 retrospective cases and 42 prospective cases. The most prevalent causes for hospitalisation related to a medical or mental health condition and dementia. Confusion and irritability were the most common forms of behaviour of concern prior to the event. Physical restraint was utilised more frequently in the prospective period compared with the retrospective period. Chemical restraint was used in approximately half of the cases in both study periods. A form of physical violence was the most prevalent behavioural symptom in both periods, followed by verbal aggression and inability to be re-directed.

Conclusion

Patients with a pre-existing medical condition, confusion and/or dementia are frequently involved in violent and/or aggressive events in ward settings. Physical and chemical restraints are commonly used to manage violence and aggression.

Implications for the Profession

Alternative strategies are needed to manage occupational violence and aggression to minimise the need for physical and/or chemical restraint.

Impact

This study addresses a gap in evidence regarding triggers, responses and outcomes for patients exhibiting violence and aggression in ward settings during hospitalisation. Patients with dementia, confusion and irritability frequently exhibit behaviours of concern, exposing healthcare workers to potential physical and psychological harm.

Reporting Method

STROBE checklist.

No Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.