Predictive Ability of the Dynamic Appraisal of Situational Aggression-Inpatient Version (DASA-IV) in Medical-Surgical Units.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
ACS Applied Bio Materials Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI:10.1177/01939459241271393
Heather Shirk, Christy Kreider, Theodore Bell, Suzanne Gervase, Barbara L Buchko, Cynthia A Danford
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引用次数: 0

Abstract

Background: Workplace violence persists in health care with nurses reporting physical and verbal abuse from aggressive patients causing emotional stress and lost workdays. The Dynamic Appraisal of Situational Aggression-Inpatient Version (DASA-IV) was developed to measure risk for aggression in patients with behavioral health conditions in psychiatric and emergency department settings. The DASA-IV has not been validated with adult patients admitted to medical-surgical units.

Objective: To determine whether DASA-IV scores are predictive of aggressive events in adults hospitalized on medical-surgical units.

Methods: This multisite study used a case-control design. DASA-IV scores and acts of aggression were extracted from the medical record retrospectively to validate the appraisal's predictability. Receiver operating characteristic (ROC) and area under the curve (AUC) were used to correlate DASA-IV scores with aggressive events.

Results: DASA-IV assessments (N=156 999; mean [SD] 10.1 [10.7]/patient; range 1-220) were collected from 13 611 patients. Patients were primarily White (86.1%) and female (51.7%). Aggression (n = 509 patients; 3.7%) was significantly associated with older age, male sex, smoking, illicit drug use, and high DASA-IV scores. AUC of the ROC analysis for the DASA-IV showed a 97% probability (95% confidence interval [CI] 0.964-0.977) that an aggressive patient would have a higher score on the DASA-IV than a nonaggressive patient. Binary logistic regression predicted that for every point increase in the DASA-IV, there was a 3.51 (95% CI 3.38-3.63) times increased risk for aggression (B= 1.255, SE = 0.18, Wald = 4766.6, P < .001).

Conclusions: This study is the first to validate use of the DASA-IV in medical-surgical populations, demonstrating predictive ability for aggressive incidents. The DASA-IV can be used successfully in medical-surgical populations for early identification of potential aggression.

情境攻击动态评估住院版(DASA-IV)在内外科病房的预测能力。
背景:医疗机构中的工作场所暴力事件屡禁不止,据护士报告,攻击性病人的肢体和言语辱骂会给护士造成精神压力和工作日损失。情境攻击动态评估-住院病人版(DASA-IV)是为测量精神科和急诊科环境中行为健康患者的攻击风险而开发的。DASA-IV尚未在内外科住院的成人患者中进行过验证:目的:确定 DASA-IV 评分是否可预测内外科住院成人患者的攻击性事件:这项多地点研究采用病例对照设计。从病历中回顾性提取 DASA-IV 评分和攻击行为,以验证评估的可预测性。采用接收者操作特征(ROC)和曲线下面积(AUC)将DASA-IV评分与攻击性事件相关联:从 13 611 名患者中收集了 DASA-IV 评估结果(N=156 999;平均 [SD] 10.1 [10.7]/患者;范围 1-220)。患者主要为白人(86.1%)和女性(51.7%)。攻击行为(n = 509 名患者;3.7%)与年龄偏大、男性、吸烟、使用违禁药物和 DASA-IV 高分显著相关。DASA-IV的ROC分析AUC显示,攻击性患者的DASA-IV得分高于非攻击性患者的概率为97%(95%置信区间[CI] 0.964-0.977)。二元逻辑回归预测,DASA-IV 每增加 1 分,攻击性风险就会增加 3.51(95% CI 3.38-3.63)倍(B = 1.255,SE = 0.18,Wald = 4766.6,P 结论:该研究首次验证了攻击性患者在 DASA-IV 中的得分:本研究首次验证了 DASA-IV 在内外科人群中的应用,证明了其对攻击性事件的预测能力。DASA-IV 可成功用于内外科人群,以早期识别潜在的攻击行为。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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