Predictors of violent incidents amongst patients in psychiatric intensive care units: A review of global evidence
2020
Aim: The objective is to identify key predictors of violent
behaviour amongst patients admitted to PICUs.
Methods: A literature search was carried out in five online databases using a predefined strategy with terms relevant to the setting and population. Articles were screened
based on the inclusion criteria and quality assessed using
the Hawker critical appraisal tool. A thematic matrix was
prepared from the final articles to highlight the pivotal predictors for violent behaviour in PICUs.
Results: Initial search without duplicates retrieved 152
articles, of which 120 were excluded after screening their
title and abstract. The full-text of 32 articles was read of
which a total of 10 studies with 4733 participants were
included in the literature review. These studies had good
designs and methodological quality. The key predictors of
violent incidents were a longer duration of in-patient stay,
higher readmission rate, non-voluntary admission to PICUs,
previous history of violence and substance misuse, permanent staff absences, being a single young male, having low
level of education and having schizophrenia.
Conclusion: The findings suggest that a variety of different factors contribute to violent incidents in PICUs. Our results may assist in the development of community and hospital-based interventions including situation management
regular staff training, promoting a friendly environment and
post-incident debriefs that can prevent future violent incidents in PICUs
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