Authors (including presenting author) :
CHAN HS (1), LAI CH (1), YU DFJ (1), CHAN WH (1)
Affiliation :
(1)Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital
Introduction :
Violence is no doubt having a high prevalence in psychiatric settings worldwide. In Hong Kong, related guidelines and instructions exist in managing violence incidents in psychiatric ward setting. However, prevention or reduction of violence was seldom mentioned. To reduce violence in psychiatric ward, a well-designed strategy, Violence Prevention Community Meeting (VPCM), had shown its effectiveness.
Objectives :
- To launch an evidence-based VPCM in female acute admission ward to both staff and patient.
- To evaluate the effectiveness of the VPCM in preventing violence outburst.
- To evaluate the effectiveness of the VPCM in reducing restraint prevalence and violence related staff injury on duty (IOD).
- To evaluate the effectiveness of the VPCM in improving number of appreciation received from patient via patient relation officer (PRO).
Methodology :
This program is a quasi-experimental non-randomized pretest-posttest design. An evidence-based VPCM was conducted to the patients at an acute female psychiatric setting together with nurses, supporting staff and occupational therapists weekly. A senior doctor would join VPCM biweekly. After implementation, we assessed its effectiveness in violence reduction, restraint prevalence, staff IOD in related to violence and number of appreciation received from patient via PRO before and after the VPCM intervention was applied. We also captured and compare the number of complaints and requests at Justice of Peace (JP) visits in 2018 and 2019.
Result & Outcome :
Although there was no statistical significance between pre (means:16.6, SD: 8.14); and post (means:15.4, SD: 8.46) intervention means in violence outburst episode, a 7.03% decrease of violence outburst episode was noted. A 24.85% of reduction in restraint prevalence and 50% of violence related staff IOD was also noted, respectively. The number of appreciation had increased markedly from 112 to 1906 as reported by PRO. The number of complaints and requests in 2018 were both 3 and 2 in 2019 at JP visits.
For the satisfaction of the intervention, over a half of the participants (52%) agreed community meeting had helped them to understand the avoidance of violence and non-violent problem-solving. Most of the participants agreed (49%) or strongly agreed (34%) the community meeting had promoted understanding and rapport between patient and staff. Also 96% of the participated was satisfactory with the community meeting and were willing to join the program in future.
