ABSTRACT
Prevention of patient-initiated violence is dependent on recognising potentially high-risk situations, and different forms of assault. Patient-initiated violence is increasingly common in medical practice and is a reflection of increasing community violence. While zero tolerance is a superficially attractive proposition, most doctors find it ineffective in practice as it usually only deflects violent behaviour onto other colleagues or to the wider community. Patients who display violent behaviours usually have an underlying disorder which requires assertive clinical management. The prevention and management of patient-initiated violence is largely dependent on the identification and clinical management of patients at risk. Patient-initiated violence is an occupational health and safety issue. It is an issue that needs to be proactively managed by identifying the extent and nature of the risk, the factors that contribute to the risk, and the changes necessary to eliminate or control the risk.
