Implementation of the Brøset Violence Checklist on an Acute Inpatient Unit

Abstract

Problem: Following the Pandemic, the healthcare system has seen an alarming increase in the rate of workplace violence (WPV), particularly towards registered nurses (RNs). A total of 50 Behavioral Emergency Response Team (BERT) calls, responding to violent and aggressive patients, took place on a 26-bed acute surgical trauma unit at a large, academic medical facility over the last year. Purpose: The purpose of the Quality Improvement (QI) project was to implement the routine use of the Brøset Violence Checklist (BVC) to reduce the incidence of workplace violence incidents on an acute trauma inpatient unit. Methods: Data was collected using the following instruments: the Brøset Violence Screening tool and the modified Staff Observation and Aggression Screening- Revised tool (mSOAS-R). Nurses screened their assigned patients once every shift using the BVC. Nurses were encouraged to implement safety measures for patients scoring ≥ 2 on the BVC tool. The mSOAS-R tool was completed by nurses when a behavioral event requiring security/BERT occurred. Results: 86% of nursing staff (n=38) were educated to use the BVC to assess patients at risk for violence and aggression. Data shows that nursing staff screened about 29.7% of eligible patients and were 79% compliant in documenting violent event using the mSOAS-R. Last year during the months of September through November there were a total of seventeen behavioral events. During implementation of the BVC, twelve total behavioral events occurred, demonstrating a 29.4% decrease in WPV events. Conclusion: Results demonstrate a decrease in the total number of aggressive events compared to the same months from one year prior. Implementation of a standardized risk assessment tool can be an essential component in managing patient aggression and violence.