Effects of Nursing Care on Controlling the Patient's Violence in Emergency Units of Psychiatric Hospital

Considering destructive nature of aggressive patients and failure of current controlling plans of aggression in the emergency department, developing an effective continuous care model in predicting, preventing and nursing care of these patients is a nursing priority. One of the effective measures is using violence Checklist.We aimed to evaluate the effects of nursing care on controlling patients’ violence in emergency unit of psychiatric hospital in Tehran University of Medical Sciences. In this case - control study, using convenience sampling method, 200 patients admitted to Roozbeh Hospital in 2010 were assigned into two groups of about 100 people each: standardized intervention and control (routine) intervention. A questionnaire including demographic questions and Violence-imposed questions regarding aggressive signs related to 6 domains(1-confusion 2-Irritability and petulance 3- duress and stormy behaviors 4-verbal threat 5-physical threat 6- Attempted assault with objects)was used to collect the data. Nursing staff were educated for the intervention by standard checklist based on patients’ aggression. Data was analyzed with descriptive statistics, analytical tests (Chi-square and Mann-Whitney) and Spearman correlation using SPSS version 11. Findings showed that outcomes of physical threats control were better in case group compared to control group (P= 0.008). There was no significant relationship between demographic data and scores of both groups and between age and shift and duress and stormy behaviors (0<0.05). Both routine and standardized intervention were effective in controlling aggressive patient but outcomes of physical threats control were better in case group (standardized intervention) compared to control group (routine intervention). Therefore, adding some items of standardized intervention to routine intervention protocol is an effective measure for the prediction and prevention of patients’ violence in emergency wards.