Prevention of Violence in an Acute Psychiatric Unit: Spanish Validation of the Brøset Violence Checklist and Assessment of Its Predictive Capacity for Physical Restraint.

Single 30-bed closed acute psychiatric unit in one Spanish hospital, with 115 patients recruited over two months, so results may not apply to other units or countries. The number of patients with higher-risk BVC scores was small, limiting analysis of the subgroup most likely to become violent. Restraint use was observed in routine care, so differences in nurse training, de-escalation and shift staffing may have affected restraint rates as much as patient risk. BVC scores varied substantially between the first three shifts, so a single admission score may not be stable over the first 24 hours. The checklist was not tested as an intervention to reduce violence or restraint, and restraint at 1 week was not significantly predicted after adjustment. Sample size was calculated for validation rather than for follow-up analyses of restraint outcomes.

The authors declare no conflicts of interest.

Do not conclude that the Spanish BVC reduces violence or physical restraint. The study observed checklist scores and restraint use; it did not test the checklist as an intervention, and restraint at 1 week was not significantly predicted.