Implementation of a Violence Risk-Assessment Tool to Reduce Workplace Violence in a Psychiatric Inpatient Unit

Abstract

Background: Workplace violence towards health care workers on inpatient behavioral health units is a significant and ongoing clinical problem that creates a safety issue for staff and patients. Workplace violence can be reduced by implementing a violence risk assessment tool such as the Dynamic Appraisal of Situational Aggression (DASA). Purpose: The purpose of this DNP project is to evaluate the implementation of the DASA violence screening tool on an inpatient behavioral health unit for early identification of patients with high risk for violence. Methods: The project was implemented over a two-month period. The DASA screening tool was used daily to assess patients. The charge nurse and behavioral health nurse educator were involved in the implementation phase. Education and training were provided to nurses via a PowerPoint presentation. A 6-item post-training survey was provided to all the nurses to assess their understanding of the DASA tool. Additionally, a case study was provided to the nurses to assess their ability to use the DASA tool. Lastly, a post-implementation survey measured on a 4-item Likert scale was provided to assess the nurses’ perception of the DASA tool on an inpatient psychiatric unit. Outcomes: Majority of the nurses (95%) were able to understand the DASA tool, how to implement it, and when to implement it. A total of 1,251 daily DASA screenings were completed. The results revealed a 98.4% completion rate of daily DASA screenings over the two-month period. Daily DASA screening occurred for at least 1 patient 98.4% of the time. Across all days, 82% of patients had a DASA screening completed. Conclusions: The results of this project demonstrated that majority of nurses believed the DASA tool helped them identify potential of patient aggression, feel safer on the unit, helped guide the use of preventative measures, and helped reduce the risk of patient aggression.A three-year embargo was granted for this item