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Calls for new strategies to manage aggression in hospitals

A Victorian study has shed light on the incidence of violence in a paediatric hospital.

Nearly half of the violent incidents involving patients at a Melbourne children's hospital required them to be physically restrained, a study has found.

The Royal Children's Hospital in Melbourne created an eight-person team to respond to incidents of violence and aggression as part of a 14-month project.

The team - dubbed `code grey' - was activated 104 times for incidents involving both patients and visitors, according to a report by emergency physician, Dr Sandy Hopper, in the latest Medical Journal of Australia.

Forty patients aged between six and 24 were involved in 75 of the cases, with females more likely to be aggressive than males. A further 29 cases involved visitors to the hospital.

When dealing with patients, physical restraint was used in 34 out of 75 cases while sedation was used on 23 occasions.

Mechanical restraint involving padded straps was used in 15 cases and patients were confined in an emergency department `safe room' 11 times.

"Even when stipulated as a last resort, restraint is used in over half of cases involving patients and a substantial proportion of visitors (over one-third) were either escorted from the hospital or left voluntarily," the study authors wrote.

Despite this, no staff were seriously injured during the study.

However, two patients sustained self-inflicted minor injuries and one visitor suffered facial fractures in a fight with another visitor before the team arrived.

Prior to the research, there was scant information on violent incidents in children's hospitals, the authors said.

Their study found establishing aggression management teams could provide a useful response to concerns about staff safety and optimal patient care.

Brett McDermott of the Child and Youth Mental Health Service at Mater Health Services in Brisbane said data on verbal abuse and physical assaults were rare in most hospitals.

"It is reasonable to suggest that investment in aggression management strategies would be cost-effective if it leads to less violence in the workplace, less time off work and higher rates of staff retention," McDermott said.


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