Er BVC overførbart til prehospitale tjenester? - En litteraturstudie om bruk av Brøset Violence Checklist i akutte situasjoner

Abstract

Sammendrag Bakgrunn Risikovurderingsverktøyet Brøset Violence Checklist (BVC) er en sjekkliste utarbeidet for å identifisere risiko for voldsutøvelse innenfor en tidsramme på 24 timer. I ambulansetjenesten rapporteres det om en økt forekomst av vold og trusler. Ved hjelp av BVC kan prehospitalt personell bli oppmerksomme på atferd knyttet til vold, og kunne gjenkjenne farlige situasjoner. Flere ambulansetjenester har valgt å ta verktøyet i bruk, selv om det ikke er utgitt forskning som tar for seg bruk av BVC prehospitalt. Oppgavens hensikt er å undersøke om BVC er et egnet verktøy i akutte situasjoner. Dette inkluderer å undersøke BVC sin sensitivitet, spesifisitet, prediktive verdier, forholdet mellom variablene og utfordringer knyttet til tidsramme. Metode Vi har benyttet en systematisk litteraturstudie som metode for å besvare problemstillingen. Søk etter relevant litteratur har blitt gjennomført i MEDLINE, CINAHL, PsycINFO og Oria. Fem enkeltstudier ble valgt ut i henhold til inklusjon- og eksklusjonskriterier.

Abstract Introduction Brøset Violence Checklist (BVC) is a risk assessment tool designed to identify the risk of violence within 24 hours. In the ambulance service, an increased incidence of violence and threats is reported. With the help of BVC, prehospital personnel can become aware of behaviour related to violence and be able to recognize dangerous situations. The purpose of this bachelor thesis is to investigate whether BVC is a suitable tool for prehospital services. This includes examining BVC's sensitivity, specificity, PPV and NPV, and the relationship between the variables and challenges related to time perspective. Method A systematic literature study was used as a method to answer the research question. Relevant literature were found using MEDLINE, CINAHL and PsychINFO as well as Oria. Five studies were included according to the inclusion- and exclusion criteria. Results Time frames varied from 8 to 24 hours. The articles showed an average of 52,94% in sensitivity. Specificity had an average of 97,26%. PPV was between 10,9% to 55%. NPV results were between 99,3% and 99,6%. Irritability and confusion were the most frequently scored variables. Physically threatening, verbally threatening and attacks on objects were scored the least but showed better predictive ability. Conclusion BVC showed satisfying results in all the included studies. We believe this risk-assessment tool can have a place in prehospital services, though a lower PPV than in the included studies should be expected. Even though the included studies have shorter time frames than most other studies, there is still a vast difference compared to the time prehospital personnel spend with their patients. This study has revealed the need for further research in the prehospital environment and in a general population.