A team of independent registered nurses have developed a risk-assessment tool that can help predict which patients are likely to become violent during inpatient stays.

Although the tool was developed for use in medical and surgical units, the nursing experts acknowledged that violent or aggressive behaviors occur in all healthcare settings, including nursing homes. For example, it is not uncommon for memory care residents to become aggressive with caregivers when they are agitated.

The 10-point tool, called the Aggressive Behaviour Risk Assessment Tool (ABRAT), was tested on more than 2,000 patients admitted to an acute care hospital in the U.S. over a five-month period. Investigators found less than one percent of the patients with an ABRAT score of zero became violent, compared to 41% of the patients with a score of two or more. Among other key findings: half of the violent incidents involved patients over the age of 70, despite the fact that they only made up 40% of the patients studied.

The five most common predictors of violence were: confusion/cognitive impairment, anxiety, agitation, shouting/demanding and a history of physical aggression, according to the researchers. The study was published in the November issue of the Journal of Advanced Nursing.