Bottom line:  There is some limited evidence that use of risk assessment tools can predict violent behavior by patients and can be associated with  reduction in aggressive incidents.

A systematic review in JBI+ COnNECT (JBI Library of Systematic Reviews. 2009;7(6):175-223) identified one retrospective study (Kling, 2006) of a tool to assess inpatients for risk of violent behavior.  In PubMed this reference led to other studies, including an RCT (Abderhalden, 2008) and a pilot study (Fluttert 2011)

Kling, R., et al., Use of a violence risk assessment tool in an acute care hospital: effectiveness in identifying violent patients. AAOHN Journal, 2006. 54(11): p. 481-7. (Available in print at Health Sciences Center Library.)
Reviewed charts at 1 acute care hospital for 117 violent patients and 161 randomly selected, nonviolent patients admitted during the same period.  Compared findings of a risk assessment tool in these populations.  Tool had moderate senstivity (71%) and high specificity (94%).  Limitation – only 35% of the non-violent patients and 75% of the violent patients were evaluated using the tool.

Abderhalden C, et al. Structured risk assessment and violence in acute psychiatric wards: randomised controlled trial. Br J Psychiatry. 2008 Jul;193(1):44-50.
Cluster RCT randomized 14 psychiatric units to use of Swiss version of the Brøset Violence Checklist (BVC–CH) or usual care for patients admitted to these units.  RESULTS: Adjusted RR indicate 41% reduction in severe aggressive incidents and a 27% decrease in use of coercive measures.  There was no decrease in severity of aggressive incidents.

Fluttert FA, et al. The development of the Forensic Early Warning Signs of Aggression Inventory: preliminary findings toward a better management of inpatient aggression. Arch Psychiatr Nurs. 2011 Apr;25(2):129-37.
Describes development of a new risk assessment tool.

PubMed search:  “Inpatients/psychology”[mesh] AND “Violence/prevention and control”[mesh] AND assess*

Reviewed 4/18/14  AA