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The development and evaluation of a brief risk screening instrument for the psychiatric inpatient setting
Author(s) -
Nicholas Holdsworth,
Betty Collis,
Rory Allott
Publication year - 1999
Publication title -
journal of psychiatric and mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 63
eISSN - 1365-2850
pISSN - 1351-0126
DOI - 10.1046/j.1365-2850.1999.00179.x
Subject(s) - medicine , clinical judgement , judgement , risk assessment , psychiatry , psychiatric hospital , medical emergency , emergency medicine , computer security , political science , computer science , law
This paper reports on the development and evaluation of a risk screening instrument (RSI) intended for use by nursing staff on general acute psychiatric admission wards. The RSI comprised six questions concerning patient status on admission (e.g. sex, legal status, employment) and 11 items of judgement concerning the presentation of the patient (e.g. threatening behaviour, suicidality, family and social support). The inter‐rater reliability of the RSI was calculated to be 85% overall. The predictive value of the RSI was not confirmed when tested against harmful incidents subsequent to admission. However, the mean RSI score of that group of patients involved in harmful incidents tended to be higher than that group of patients not involved in such incidents, and all such incidents were found to occur within eight days of admission. Analysis of other data collected in the course of the study revealed discrete patient groups and provided systematic insights into their characteristics, which are potentially valuable when considering the nursing skills required on acute psychiatric inpatient units. It is concluded that the RSI tested has the potential to contribute to the assessment and management of risk within the acute psychiatric inpatient setting, by augmenting and guiding clinical judgement.