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The National Audit of Violence: in-patient care for adults of working age

  • Robert Chaplin (a1), Maureen McGeorge (a2) and Paul Lelliott (a2)
Abstract
Aims and Method

We audited 184 psychiatric wards against clinical practice guidelines for the management of violence. Staff and service users completed anonymous questionnaires. Environmental inspections were performed by two teams.

Results

There were 4460 questionnaires returned. Nurses (78%) were significantly more likely to report the experience of violence than service users (37%). Drugs were reported by 72% of nurses and alcohol by 61% as causing problems. Other standards frequently not met included staffing levels, training, provision of activities, ward design and ambience.

Clinical Implications

Specific issues are identified that must be addressed by national and local action. A baseline is set against which the impact of this action can be judged. Priorities must include tackling drug and alcohol use in psychiatric wards.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Department of Health (2000) Managing Violence in Mental Health and Managing Violence in the Community. London: Department of Health.
Department of Health (2002) Mental Health Policy Implementation Guide: Adult Inpatient Care Provision. London: Department of Health.
Department of Health (2004) The National Service Framework for Mental Health – Five Years On. London: Department of Health.
Healthcare Commission (2005) The National Audit of Violence (2003–2005). Final Report. http://www.healthcarecommission.org.uk/_db/_documents/04017451.pdf
Lelliott, P. (2004) The National Patient Safety Agency. Psychiatric Bulletin, 28, 193195.
Marshall, H., Lelliott, P. & Hill, K. (2004) Safer Wards for Acute Psychiatry. London: National Patient Safety Agency. http://www.npsa.nhs.uk/site/media/documents/1241_SWAP_ResearchReport.pdf
McGeorge, M., Lelliott, P. & Stewart, J. (2001) Managing violence in psychiatric wards: preliminary findings of a multi-centres audit. Mental Health Care, 31, 366369.
National Institute for Clinical Excellence (2005) Violence: The Short Term Management of Disturbed / Violent Behaviour in Inpatient Psychiatric Settings and Emergency Departments. London: NICE. http://www.nice.org.uk/page.aspx?o=cg025fullguideline
Pieters, G., Speybrouck, E., De Gucht, V., et al (2005) Assaults by patients on psychiatric trainees: frequency and training issues. Psychiatric Bulletin, 29, 168170.
Quirk, A., Lelliott, P. & Seale, C. (2006) The permeable institution: an ethnographic study of three acute wards in London. Social Science and Medicine, 63, 21052117.
Royal College of Psychiatrists (1998) The Management of Imminent Violence: Clinical Practice Guidelines to Support Mental Health Services (Occasional Paper OP41). London: Royal College of Psychiatrists.
Wildgoose, J., Briscoe, M. & Lloyd, K. (2003) Psychological and emotional problems in staff following assaults by patients. Psychiatric Bulletin, 27, 295297.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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The National Audit of Violence: in-patient care for adults of working age

  • Robert Chaplin (a1), Maureen McGeorge (a2) and Paul Lelliott (a2)
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