Attitudes of nurses and nurse managers towards violence risk assessment and management: A cross-sectional study in psychiatric inpatient settings

What is known on the subject

• Workplace violence is a significant challenge in psychiatric hospital care.
• Some existing practices of violence risk assessment and management are based on nurses' intuition and clinical experience instead of structured tools.

What the paper adds to existing knowledge

• Nurses and nurse managers consider violence risk assessment and management their responsibility. Still, nurses and nurse managers have mixed attitudes towards the use of validated risk assessment tools.
• The attitudes towards service users' positive risk-taking in nurses and nurse managers vary, with some nurses and nurse managers supporting its importance.

What are the implications for practice

• Change in nurses' and nurse managers' attitudes towards risk assessment tools is required before their implementation into practice.
• More profound change in practices towards recovery-oriented care is required also in risk assessment.

Introduction

Workplace violence is a prevalent issue in psychiatric inpatient care. Prevention efforts require the identification of at-risk service users using validated violence risk assessment tools. The shift in violence prevention emphasises preventive measures and collaborative risk assessment together with service users. Nurses have a central role in this process. Therefore, their attitudes are crucial when implementing evidence-based methods.

Aim

To assess the attitudes of nurses and nurse managers towards violence risk assessment and management.

Method

A cross-sectional online survey in Finnish psychiatric inpatient care. Data analysis was conducted with statistical methods. The STROBE guideline was used in reporting.

Results

Nurses (n = 142) valued risk assessment and felt that it was their responsibility. Attitudes towards service users' risk-taking as part of their recovery varied. Nurses had mixed attitudes regarding the effectiveness of risk assessment tools. Older participants and nurse managers had more positive attitudes towards risk assessment tools.

Discussion

The study findings highlight a feeling of responsibility of nurses towards violence risk assessment and at the same time their preference towards their own clinical judgement.

Implications for Practice

Understanding nurses' attitudes is crucial in training and implementation processes to address concerns, provide support and enhance positive attitudes.