On-Demand Learning Lab: Getting Serious about the Safe Management of Behavioral Patients-Broset Violence Checklist

Broset Violence Checklist

Pdf Summary

The document provides quick instructions and scoring guidance for the Brøset Violence Checklist (BVC), a brief tool used to assess a patient’s short-term risk of violence. Staff score the patient at an agreed time each shift (day, evening, night) across the week. For each of six observable behaviours, absence scores 0 and presence scores 1, producing a total (SUM) from 0 to 6. If a behaviour is normal for a well-known patient, it is scored 0 unless there is a noticeable increase (e.g., long-standing confusion scores 0 unless worsened).<br /><br />The weekly scoring form lists the six items to rate each shift: confused, irritable, boisterous, verbal threats, physical threats, and attacking objects, with a SUM recorded for each shift/day.<br /><br />Interpretation of the total score is outlined: a score of 0 indicates low risk of violence; scores of 1–2 indicate moderate risk where preventive measures should be taken; and a score of 2 (noted in the text as “very high”) indicates very high risk, requiring preventive measures plus a management plan for potential violence.<br /><br />The document also operationally defines each behaviour to standardize scoring. “Confused” refers to obvious disorientation to time, place, or person. “Irritable” means easily annoyed/angered and intolerant of others. “Boisterous” describes overtly loud or noisy behaviour such as shouting or slamming doors. “Physically threatening” involves clear intent to threaten physical harm (e.g., aggressive stance, grabbing clothing, raising a fist). “Verbally threatening” involves intimidating verbal outbursts beyond a raised voice (e.g., abuse, name-calling, aggressive snarling comments). “Attacking objects” covers aggression toward objects (e.g., throwing items, smashing windows/furniture). The definitions for threatening behaviour and attacking objects were adapted from the Behavioural Status Index.

Keywords

Brøset Violence Checklist

BVC scoring

short-term violence risk assessment

psychiatric inpatient safety

shift-based patient observation

confusion disorientation

irritability agitation

verbal threats

physical threats

attacking objects aggression