Nurses are to offer advice as well as first aid to victims of violence as part of a pioneering new scheme to help combat the effects of alcohol and aggression.

The specially-trained nurses, based at NHS Greater Glasgow and Clyde’s Glasgow Dental Hospital, will give victims of facial injury – such as knife wounds – a brief talk on the consequences of alcohol and violence at two hospitals, Greater Glasgow’s Southern General in Shieldhall, and NHS Lanarkshire’s Monklands Hospital in Airdrie.

The three-strong team, who are now in place, will carry out the counselling as a two year trial in a joint initiative with Glasgow University Dental School’s alcohol research group. The multi-disciplinary group, chaired by Professor Ashraf Ayoub, consists of surgeons, psychologists, psychiatrists, statisticians, nurses, the RCA trust and the Violence Reduction Unit.

Hospitals in Glasgow treat a serious facial injury every six hours, with nurses caring for around 1000 victims of violence a year. Much of that violence is alcohol-related.

Mr Ian Holland, Consultant Maxillofacial surgeon at the Southern General, said:

“The majority of patients I see and treat with facial injury have that injury as a result of excess alcohol intake, often their own, but sometimes other people's. If we can influence people's drinking habits to be more sensible hopefully they will require the services of maxillofacial units far less”

It is hoped that the study, which is being funded by the Violence Reduction Unit, will address both drinking and aggressive behaviour.

The project will be co-ordinated by Dr Christine Goodall, a clinical lecturer in Oral Surgery at Glasgow University Dental School. She said:

“Patients at the two hospitals involved will be asked to take part if they have a facial injury caused by violence while they were drinking alcohol. Nurses will provide brief counselling sessions to the patients. We hope that this will help patients to both reduce their alcohol intake and to avoid violent situations in the future.

“Our long term goal is to reduce the incidence of facial injury which can be very disfiguring. Our three nurses were recruited because of their enthusiasm and commitment to trying to help patients face up to and deal with the cause of their injury. This is absolutely vital to a project such as this and we are delighted to have them in place.”

The initiative will target young men aged 16 and over, each of whom will be assessed by a nurse to see if they are suitable to take part. It is anticipated that around 300 patients will be involved.

Fiona Oakey, one of the three nurses involved in the initiative, said:

“At the moment patients don’t get any advice or help of this kind at all. The hope is that if the initiative proves to be a success it will eventually become part of our everyday work in maxillofacial clinics.”

The initiative is part of the Violence Reduction Unit’s ongoing work to develop innovative methods of containing and managing violent behaviour while at the same seeking to achieve long-term societal and attitudinal changes to violence.

Karyn McCluskey, co-director of the Violence Reduction Unit, said: “We have repeatedly stressed that the police alone cannot change such a deep-rooted culture of violence. However, by working together with our partners in the health service and elsewhere, we can begin to make significant inroads.

“This is only a pilot study and will of course be evaluated, but it is important that we use innovative methods like this to try and influence and change attitudes and behaviour to knife carrying. These nurses will be at the forefront of this pioneering scheme to help victims of facial injury.”

1. COVAID – Control of Violence for Angry, Impulsive Drinkers is an intervention programme developed by Dr Mary McMurran of the University of Nottingham. First trialled in Cardiff, the programme aims to encourage people to control their anger, stop and think in response to problems and control their drinking. An evaluation of the Cardiff programme showed that all participants had so far shown improvement in aspects of anger control and problem solving, and that incidents of aggression and violence had been minimal for the duration of the course. The chances of re-offending were twice as high for people who did not complete COVAID compared to those who did.
2. Nurses will talk to patients during their initial treatment and follow up their progress with phone calls. Patients will subsequently be tracked over five years by their NHS number to see if they return to hospital under similar circumstances.
3. The pilot team of three nurses is now in place. Two will be based at the Southern General and the third at Monklands Hospital

SS-COVAID Proposal