Violence Prevention Climate in General Adult Inpatient Mental Health Units: Validation study of the VPC-14.
Geoffrey L Dickens, Tracy Tabvuma, Kylie Hadfield and 1 others
PMID 32536025WHAT IT FOUND
The VPC-14 questionnaire gave useful ward violence-prevention ratings in adult mental health units, but the patient-actions part was weaker and scores did not change after conflict and containment fell.
Use it to compare wards, not to prove improvement.
Key findings
01The whole VPC-14 scale and the staff-actions subscale were reliable, but the patient-actions subscale was below the acceptable threshold until items 7 and 9 were removed.
02Patients rated their own violence-prevention actions more favourably than staff did, while staff and patients gave similar ratings of staff actions.
03After Safewards implementation, reported conflict incidents fell by 29.1% and containment incidents by 14.6%, but VPC-14 scores did not change between the first and second questionnaire rounds.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 213 usable questionnaires were analysed, and response rates were 25.4% for staff and 25.3% for patients, so respondents may not represent all ward staff or patients. Repeat questionnaires were treated as independent because respondents were anonymous, which could inflate reliability estimates. The patient-actions subscale was below the acceptable reliability threshold until items 7 and 9 were removed. The VPC-14 did not change after reported conflict fell by 29.1% and containment fell by 14.6%, so it may not be sensitive enough to detect improvement. Rasch analysis found that five low scorers and 34 high scorers were not adequately captured, and some items clustered together. The study was conducted in one local health district in New South Wales, so other settings may differ.
Declared interests
The study was funded by a Strategic Reserve Funding grant from the Nursing and Midwifery Office, New South Wales Government. The funder played no part in design, conduct, data collection, analysis or the decision to publish.
The easy way to misread this
Do not treat the VPC-14 as a proven way to detect improvement after an intervention. Scores did not change between the first and second questionnaire rounds even though reported conflict fell by 29.1% and containment fell by 14.6%.