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    Violence Aggression Assessment Checklist

    Uploaded by

    Stella Gašparuš

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Violence Aggression Assessment Checklist

    Uploaded by

    Stella Gašparuš
    91 views2 pages

    Original Title

    Violence_Aggression_Assessment_Checklist

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    91 views2 pages

    Violence Aggression Assessment Checklist

    Uploaded by

    Stella Gašparuš

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Violence/Aggression

    Assessment Checklist (VAAC)


    To be completed by referral source

    Patient’s name: Date of birth: DD / MM / YY

    Known history of violence q No q Yes If yes, please provide the date and a brief description of the last known incident.

    Date Description

    TYPE OF BEHAVIOUR EXHIBITED Yes / No DESCRIPTORS

    Uncooperative q No Easily annoyed or angered. Unable to tolerate the presence of others. Will
    q Yes not follow instructions.

    Verbal Abuse q No Verbal attacks, abuse, name calling, verbally neutral comments uttered in a
    q Yes snarling, aggressive manner

    Hostile/Attacking Objects q No Overtly loud or noisy, i.e. slams doors, shouts out when talking, etc. An
    q Yes 
    attack directed at an object and NOT at an individual i.e. the indiscriminate
    throwing of of an object, banging or smashing windows, kicking, banging,
    head-banging, smashing of furniture

    Threats q No A verbal outburst which is more than just a raised voice; and where there
    q Yes is definite intent to intimidate or threaten another person. A definite intent
    to physically threaten another person, i.e. raising of arm/leg, aggressive
    stance, making a fist, etc.

    Assaultive/Combative q No An application of force or attack directed at an individual, i.e. kick, punch,


    q Yes spit, grabbing of clothing, use of a weapon or weapon of opportunity.

    Known risk factors/triggers

    Mitigation strategies for known


    risk factors/triggers

    BEHAVIOUR Level of Risk CURRENT RISK MITIGATIONSTRATEGIES/INTERVENTIONS

    No observed behaviour Low


    Uncoorperative OR
    verbal abuse/aggression Moderate
    One or more of the above shaded
    Both of the non-shaded OR High
    significant history of violence

    Print name: Signature:

    Date/Time received from Referral Source:

    Update - Date/Time received from Referral Source:


    Violence/Aggression
    Assessment Checklist (VAAC)
    To be completed by The Royal Managers - PCS

    Patient’s name: Receiving unit:

    Date received: Date posted on unit:

    VACC RECEIVED MY MANAGER

    Print name: Signature:

    Date: Time:

    Risk assessment q Low q Moderate q High

    INTERPROFESSIONAL PLAN AND MITIGATION STRATEGIES

    q Routine observation and procedures GPA q No q Yes

    q Intermittent observation q PRNs/Medications administered at/prior to admission

    q Constant observation q Equipment needs

    q Flagging protocol/yellow dot q Gender specific staff

    q Extra staff

    q Other

    Admission delayed q No q Yes

    Rationale:

    COMMUNICATION TO STAFF

    q Direct communication to staff

    q Posted on unit flow/VAAC board

    q Safety huddle discussion

    Accuracy of information from Referral Source:

    Adapted from: Broset Violence Checklist (R. Almvik & P. Woods, 2000) : Alert System risk Indicators (R. King et al., 2006) , Correlates of accuracy in the assessment of Psychiatric Inpatients’
    risk of violence (D. McNeil & R. Binder, 1995) and Violence/Aggression Assessment Checklist (VAAC) PSHSA 2010. All rights reserved

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