In this case, a client named Wong Kai Long who is a 56 years old taxi driver. He is living with wife and son in a public house unit. He worked as a bus driver for 23 years and was being dismissed 1 year ago after involving in a bus traffic accident.
For the information collected from Mr. Wong’s, Mr. Wong had mental problems since 3 months ago and elicited paranoid ideas for several times that staffs of previous bus company had ganged up to victimize him in the traffic accident. Moreover, his wife stated that he had a poor sleep problem, self-muttering and even scolded her and their son with foul language for no apparent reasons. In three days earlier, he scolded to air as if he was hearing voices and verbal threatened that …show more content…
The DASA assessment is a concise and organized instrument developed for assessment of impending aggressive behaviour within the next 24 hours. It includes seven components which were negative attitudes, impulsivity, verbal threats, sensitive to perceived provocation, irritability, easily angered when requests are denied and unwillingness to follow instructions (Ogloff & Daffern, 2006).
Additionally, these components aim to enhance predictive validity and assist in targeting patient for intervention so as to facilitate the prevention of violent behaviour (Ogloff & Daffern, 2006). There were studies showed that use of DASA was more precise in identifying forthcoming violence than the use of clinical judgment and experience only (Griffith, Daffern, & Godber, 2013).
Some people argued that this standardized risk assessment tool is only effective in a forensic psychiatric settings (Underwood, 2017). However, in the crisis or emergency psychiatric settings, where urgent assessment and management are crucial in patient and staff security, risk assessment instrument may not be applicable (Sands, Elsom, Gerdtz & Khaw, …show more content…
Besides, when patient elicited delusion or hallucinations with violent content, unobtrusive observation should be maintained to further investigate its frequency and intensity. Moreover, nurse should be alert and leave the scene once if a client started to express verbal threat with dilated pupils and increased breathing and heart rate. Furthermore, a nurse should pay special attention to patient’s behavior similar to that which preceded earlier disturbed or violent episodes. Lastly, a nurse must apply breakaway technique and call for help immediately when a patient attempted to block escape routes and use of physical violence. The identification of risk factors and early warning signs of violence during the initial assessment processes enhances the possibility for prevention (Sands,