A rapid review of violence risk assessment tools currently used along the emergency care pathway

Background
Violence against staff working in emergency care is a pervasive global problem. The consequences are wide-ranging, impacting staff psychologically, physically, and professionally, while staff sickness following workplace violence has significant cost implications. Despite the availability and increasing use of violence risk assessment tools, most have limited supporting evidence in emergency care settings.

Aims
To collate primary literature evaluating the psychometric properties, acceptability, feasibility and usability of violence risk assessment tools used along emergency care pathways (emergency departments [EDs] and acute medical units [AMUs]).

Methods
We undertook a rapid review, searching: Embase, Medline, Web of Science, CINAHL and Google Scholar. We excluded studies conducted within specialist emergency care settings (e.g., paediatric or psychiatric) or focused on violence occurring outside of hospital. All studies underwent quality appraisal, and findings were synthesised narratively.

Results
Eight studies met our inclusion criteria, all conducted in either the USA or Australia, and all focused on ED settings. Seven tools featured across the studies, four of which were developed specifically for use in ED. The evaluated psychometric properties were diverse, including measures of predictability, usability, validity and reliability. Overall, the studies concluded very mixed findings about the tools’ psychometric properties.

Discussion
Due to the heterogeneity of included studies, it is difficult to draw conclusions about the generalisability of any one tool. However, individual study findings indicate that many of these tools are appropriate and acceptable for use in ED settings. None of the studies included AMUs, which highlights a significant gap in the literature, given the distinctiveness of this subspeciality area.

Conclusions
Existing violence risk assessment tools have produced varying results in ED settings. The recentness of much of the literature in this area suggests this clinical issue is gaining traction. Future research should focus on incorporating and evaluating violence risk assessment in AMUs.

Biography
Dana is a registered adult nurse and research associate currently working on various academic projects at the University of Birmingham. Her research interests include violence, gender-based violence, child maltreatment and healthcare education.