Mitigating Patient Violence Within Inpatient Psychiatric Facilities

Psychiatric facilities have a high rate of violence against staff and patients, resulting in negative consequences for the organization. The purpose of this integrative review is to search the existing body of knowledge regarding violence risk assessment (VRA) tools and their ability to function as a resource used to monitor conditions (patient behaviors) within the psychiatric environment in efforts to mitigate patient violence. VRA tools have been found to minimize violence in the workplace by enhancing staff awareness and serving as a resource used to collect information and assist in implementing effective interventions. An integrative review was conducted consisting of literature published between 2013–2024. This study surrounds the situational awareness theory. Situational awareness requires that the correct information be available at the right moment to the right person who is ready to receive it, can process it, and can act on it. Results: The thematic analysis identified four key themes: (a) Patient Observation; (b) Education; (c) Risk Management; and (d) Tool Validity and Reliability. In addition, 11 subthemes were identified: behavioral indicators, dynamic factors, real-time assessments, inter-rater reliability, predictive validity, patient safety, risk assessment, targeted clinical interventions, proactive management, improved documentation, and staff confidence. Healthcare leaders should consider effectively training staff in being attentive and aware of patient behaviors that could lead to violence. Implementing VRA tools in psychiatric facilities can promote a healthy and safe milieu by aiding staff in identifying potential violent behaviors, which in turn can reduce incidents and lead to interventions that will produce positive social change and clinical outcomes.