Hager, Morgan, BSN, RN

Petillo, Alyssa L, BSN, RN

Reilly, Meghan A, BSN, RN

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingPredicting Violent Outbursts In The EmergencyDepartment Using The Bröset Violence Checklist(BVC) (Poster).Alyssa L. Petillo BSN, RNLehigh Valley Health Network, alyssa_l.petillo@lvhn.orgMeghan A. Reilly BSN, RNLehigh Valley Health Network, meghan_a.reilly@lvhn.orgMorgan Hager BSN, RNLehigh Valley Health NetworkFollow this and additional works at: https://scholarlyworks.lvhn.org/patient-care-services-nursingPart of the Nursing CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtPetillo, A., Reilly, M., & Hagar, M. (2016, July 20). Predicting Violent Outbursts In The Emergency Department Using The Bröset ViolenceChecklist (BVC). Poster presented at LVHN Vizient/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network,Allentown, PA.© 2016 Lehigh Valley Health NetworkLehigh Valley Health Network, Allentown, PennsylvaniaPredicting Violent Outbursts In The Emergency DepartmentUsing The Bröset Violence Checklist (BVC)161Change In BVC Score For Medicated PatientsDecreaseIn ScoreIncrease InScore• 52 patients were observed during our study period. Of these, 25 patients scored >1 throughout their stay in the ED.2.70.350123Average BVC Score In Relation to MedicinalInterventionPre‐Medication30 MinutesPost‐MedicationAlyssa Petillo, BSN, RN            Morgan Hagar, BSN, RN            Meghan Reilly, BSN, RNBACKGROUND METHODSCONCLUSIONSRESULTSPICO QUESTION• First hand experience at the bedside led us to uncover an absence of a formula that corresponds to a patients’ behaviors that are predictive of violent outbursts. • The Bröset Violence Checklist (BVC) consists of six violence risk predictors, where if a patient exhibits the behavior, they score a “1” for that category, and if they are not exhibiting that behavior, they score a “0.” These are then added together to get the patients score. The risk behavior categories include: confusion, irritability, boisterousness, verbal threats, physical threats, and attacking objects.• The BVC provides staff with information about each patients, “propensity for aggression…allowing staff to implement biopsychosocial interventions and preventitive strategies to avert aggression...” (Chu, Daffern, & Ogloff, 2013).• Amongst 54.81% of Cedar Crest ED nursing staff, the average number of times a nurse placed a patient in violent restraints/seclusion was >15.• Amongst 54.81% of Cedar Crest ED nursing staff, the number of IM medications given to a violent psychiatric patient was >15. These medications included Ativan, Haldol, Cogentin, and Valium.REFERENCES• A meeting was held with all charge nurses and the education committee to discuss the project and demonstrate usage of the BVC.• An email was sent to all 135 Cedar Crest ED nurses with instructions for completion and a sample completed checklist for reference.• A folder with blank copies of the BVC was placed at the nurses computer for beds 19 and 20, where we primarily keep our acutely ill psychiatric patients.Instructions and a sample of a completed scale were attached to this folder.• Following a two month pilot study in the ED, a questionnaire regarding satisfaction and experience was sent to all 135 Cedar Crest ED nurses. • Does the use of the BVC accurately predict violent outbursts in the Emergency Department in the acutely ill psychiatric population, therefore, leading to early intervention?178Patients With BVC Score >1MedicatedNotMedicated• 64.86% of respondent’s believe that our acutely ill psychiatric patients are not medicated in a timely fashion.• Zero patients were restrained after pharmacological intervention.• Data collected through our pilot study revealed that the Bröset Violence Checklist accurately predicts violent behavior in the psychiatric patient population presenting to the ED.Chu, C. M., Daffern, M., & Ogloff, J. R. (2013). Predicting aggression in acute inpatient psychiatric setting using BVC, DASA, and HCR‐20 Clinical scale. The Journal of Forensic Psychiatry & Psychology, 24(2), 269‐285. Time Assessment Performed    Confused 0  Irritable 1  Boisterous 1  Verbal Threats 1  Physical Threats 0  Attacking Objects 0  Total Points 3     Impulsivity Question: Do you do or say things without thinking?  Yes/No  Yes/No  

Predicting Violent Outbursts In The Emergency Department Using The Bröset Violence Checklist (BVC) (Poster).

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1650&context=patient-care-services-nursing

Predicting Violent Outbursts In The Emergency Department Using The Bröset Violence Checklist (BVC) (Poster).

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