The Aggression and Violence Evaluation of Risk Tool: A Context-Specific Instrument to Assess Risk of Violence in the Emergency Department.
Elisa Ilarda, Ainslie Senz, Peter Mcilveen and 1 others
PMID 41103071WHAT IT FOUND
In a busy emergency department, bedside nursing observations of history of violence, drug or alcohol influence, agitation or restlessness, and imposed restrictions were associated with emergency security responses to violence.
This was not tested to prevent violence.
Key findings
01Seven of the 14 tested factors were significant predictors of emergency security responses: drug and alcohol influence, history of violence, agitation/restlessness, imposed restrictions, verbal threats, physical threats, and attacking objects.
02Verbal threats, physical threats, and attacking objects were excluded from the final tool because they represent manifestations of violence rather than predictive indicators.
03The four remaining factors formed AVERT and had an AUC of 0.98; this was not statistically different from the existing BVC.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted at a single emergency department where the BVC and a risk mitigation system were already routine, which may limit generalisability. Only 39.8% of presentations during the study period were captured, and forms with incomplete dynamic factor data were treated as missing. The scoring of violence risk factors involves subjectivity. The outcome analysed was emergency security response; planned code greys were not analysed because they measure potential rather than actual violence. The study did not test AVERT as an intervention to reduce violence; the existing BVC procedure, not the new factors, determined management.
Declared interests
The authors declared no conflict of interest. The supplied text includes a Funding heading but does not name a funder.
The easy way to misread this
Do not conclude that AVERT should replace the existing BVC or that it prevents violence. It was derived and tested in a single emergency department where the BVC was already routine, and its discrimination was not statistically different from the BVC.