Cross-sectional survey of disturbed behaviour in patients in general hospitals in Leeds

Aim: To describe the prevalence and nature of disturbed behaviour, in the general hospital setting. Method: A cross-sectional survey was conducted, from July to October 2006, in all adult inpatient wards within the six general hospitals in Leeds of patients presenting with disturbed behaviour in the preceding 7 days. Disturbed behaviour was defined as behaviour interfering with care of the patient or with that of other patients, or behaviour that placed the patient, the staff or others at risk. Anonymised data were collected using a semi-structured questionnaire. Results: All of the 87 hospital wards were studied, containing a total of 1773 beds. 42 male and 26 female patients (n= 68) were identified by nursing staff as patients with disturbed behaviour in the time period covered, with 33 patients being <= 65 years of age and 35 being elderly (>65 years of age). An almost equal proportion of the younger and older patient groups placed themselves or others at risk. In the majority of cases, aggressive behaviour by patients was directed towards staff rather than other patients. 60 patients required additional staff time due to the disturbed behaviour, 34 required additional medication, and 22 patients were referred to liaison psychiatry. Conclusions: Disturbed behaviour presents in the general hospital in less than 4% of patients, both above and below the age of 65 years, but consumes a disproportionate amount of resources. Responses required to manage this include additional medication, additional staff time or other interventions. The quantity and nature of disturbed behaviour in the general hospital have implications for effective service provision and development.