A study published in the February 20 issue of the Medical Journal of Australia, reveals that a formal aggression management system can help control aggression and violence in hospitals.

The Medical Journal of Australia is a publication of the Australian Medical Association.

According to Dr. Sandy Hopper, an emergency physician at the Royal Children’s Hospital in Melbourne, and colleagues, the hospital created a team called “code grey” in order to respond to incidents as well as to “improve clinical risk, staff safety and patient care.”

The team was called upon 104 times (75 patient cases and 29 visitor cases) during a 14 month period. The incidents occurred at same frequency in the emergency department and onwards. The team found that males were less likely to be aggressors than females.

In 34 out of 75 cases the team used forceful measures, such as physical restraint, mechanical restraint (involving padded straps) in 15 out of 75 cases, and sedation in 23 out of 75 cases, and confinement “safe room” in an emergency department 11 times.

The researchers explained:

“Even when stipulated as a last resort, restraint is used in over half of cases involving patients, and a substantial proportion of visitors (over one-third) were either escorted from the hospital or left voluntarily.”

According to the researchers, no serious injuries to staff occurred during the study period, although one visitor inflicted facial fractures on another visitor before the team had arrived, and two patients sustained self- inflicted minor injuries. During physical or chemical restraint no patients were injured, the researchers report.

In an associated report, Brett McDermott from the Child and Youth Mental Health Service at Mater Health Services in Brisbane explained that in several hospitals, there is insufficient reliable data on physical assaults and verbal abuse, the management response is ad hoc and staff receive no training to manage aggression.

McDermott said:

“It is reasonable to suggest that investment in aggression management strategies would be cost-effective if it leads to less violence in the workplace, less time off work and higher rates of staff retention.”

Written by Grace Rattue