SAN DIEGO–(BUSINESS WIRE)–New findings from the ABRAT™-H interventional study, involving over 7,000 hospitalized patients, demonstrate significant reductions in patient violence and physical assaults, mirroring the positive outcomes previously observed in the Aggressive Behavior Risk Assessment Tool for Emergency Departments (ABRAT™-ED) study of over 77,000 patients in the ED setting. The study, “A workplace violence prevention program targeting high‐risk patients in emergency departments,” is available here.
The ABRAT™-H study concludes that screening with the Aggressive Behavior Risk Assessment Tool for Hospitalized Patients combined with targeted signage posting, with or without Behavioral Health Response Nurse (BHRN) rounding for the high-risk patients, was effective in preventing violence and physical assaults among hospitalized patients. The study, “Aggressive Behavior Risk Assessment Tool for Hospitalized Patients in Non-Psychiatric Inpatient Units,” is available here.
Study Design and Methodology
The ABRAT™-H study was conducted in Omaha, Nebraska, USA, from November 2024 to August 2025, focusing on hospitalized patients, whereas the ABRAT™-ED study was conducted among patients who visited two EDs in Grand Rapids, Michigan, USA. The ABRAT™-ED study evaluated more than 77,000 patients visiting EDs and was a 10-month prospective interventional study.
Both ABRAT™-H and ABRAT™-ED studies utilized similar designs with a baseline observational period and two interventions introduced in a stepwise fashion. The violent event types and severities data were captured using the Violent Event Severity Tool (VEST™). The study, “Violent Event Severity Tool for Reporting Violent Incidents,” is available here.
In the two studies, patients at high risk for violence in ED or inpatient-hospital settings were identified using the ABRAT™-ED or ABRAT™-H screening tools, respectively. Following the baseline observational periods, the interventions implemented stepwise were:
1. Phase 1: Simple signage posting for high-risk patients per ABRAT™-ED or ABRAT™-H.
2. Phase 2: A proactive Behavioral Emergency Response Team (BERT) huddle or Behavioral Health Response Nurse (BHRN) rounding added to the signage posting for the high-risk patients.
Similar Positive Results in Violence Reduction
The ABRAT™-H study for hospitalized patients showed similar positive results as those demonstrated for patients visiting the ED in the ABRAT™-ED study, i.e. significant decreases in overall violence rates as well as reductions in physical assaults.
In the earlier ABRAT™-ED study, the intervention of signage posting alone (Phase 1) was found to be effective in reducing violent events. The relative risk (RR) of violent events for Phase 1 compared to the baseline was 0.73, a statistically significant reduction in violence (p = 0.003).
The positive results from these two interventional studies confirm that the ABRAT™-H and ABRAT™-ED are the only validated tools shown to reduce violence in two separate settings, i.e. EDs and hospital inpatient units, through identification of potentially violent patients. Dr. Christina Vejnovich, a co-Principal Investigator of the ABRAT™-H study and Clinical Nurse Specialist at Nebraska Methodist Hospital, states, “The nursing staff on the study units were highly supportive of the study interventions and expressed strong appreciation for the organization’s participation in proactive efforts to prevent and reduce workplace violence.”
Workplace violence (WPV) in EDs and hospitals
WPV against healthcare workers is a serious preventable problem. The U.S. Bureau of Labor Statistics reported that hospitals are associated with a sixfold higher rate of WPV-related injuries compared to all industries, and healthcare workers suffer threefold higher absences from work due to WPV-related injuries. These US statistics have been worsening steadily since their reporting began in 2011. Among healthcare workers in the United States, more than two nurses experience assaults every hour, and patients are the most common perpetrators. WPV can have negative impacts on patients, nurses and hospitals, such as poor patient care, anxiety, job dissatisfaction, burnout, high turnover, low productivity and financial loss for the organizations. To address the worsening WPV problem, The Joint Commission recently issued new and updated standards for WPV prevention programs required for hospital accreditations. The new standards include the implementation of WPV prevention programs, annual program evaluations, as well as standardized data collection and reporting of WPV. The VEST™ is a validated tool for collecting various violent-event types and their severities in a standardized fashion, consistent with current regulatory requirements.
About Son Chae Kim, PhD, LLC
Son Chae Kim, PhD, RN, is the founder of the organization. In collaboration with colleagues across the US and Canada, Dr. Kim has developed and validated ABRAT™ and VEST™ over the past decade to prevent workplace violence in healthcare. Learn more at www.sckim.com.
ABRAT™-H, ABRAT™-ED and VEST™ licensing information
Copyright licenses are available.
Contacts
Ken Martin
Son Chae Kim, PhD, LLC
VP of Sales and Marketing
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760-330-1630
