The role of family visits, staffing, admissions and discharges, weekday, birthdays, and census in the prediction of violent incidents in a forensic setting
There is growing concern that the incidence of violence in psychiatric settings is increasing. Studies of violence in hospital wards have mostly focused on patient characteristics such as age, sex, race and diagnosis. This patient-centered focus produced uncertain and inconclusive results, leading many researchers to call for an environmental approach in violence research. Such an approach proved more fruitful as factors such as patient density, staffing procedures, and ward atmosphere were implicated in the genesis of violence. The present study employed an environmental approach to investigate when in the life of two forensic inpatient wards is violence more, or less likely. The sample studied included all patients hospitalized in each of two male admissions wards during 21 months in a New York State forensic facility. Archival data on violence, seclusion/restraint for agitated behavior, and important aspects of daily hospital life such as admissions and census were gathered. Logistic regression analyses were performed to test the hypotheses of associations between violence or agitation, and census, admissions, discharges, family visits, birthdays, staffing procedure, and weekday. In addition, it was hypothesized that environmental events may at times trigger assaults or agitation after a time-lag of up to three days. The central hypothesis, namely that violence and/or agitation is under environmental control, was partially supported. Significant associations were found between census, weekday, admissions, discharges, family visits, and staffing by regular staff. The hypothesis of a time lag between a triggering event and the subsequent violence or agitation was partially supported. Family visits were associated with increased odds for agitation and/or violence two to three days after the visits. A different pattern of correlates of violence and/agitation emerged across the two wards studied. One ward had substantially more violence and it was suggested that factors such as staff efficacy and ward atmosphere contributed to a greater rate of violence on that ward.
Davar, David Aron, "The role of family visits, staffing, admissions and discharges, weekday, birthdays, and census in the prediction of violent incidents in a forensic setting" (1994). ETD Collection for Fordham University. AAI9425191.