Reducing Violence Against Nurses Through the Implementation of a Violence Risk Assessment Tool

• Main Author: Fox, Clare
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2022
• Subjects: Nursing; Occupational safety; Psychology
• ISBN: 9798380306652

Problem: Nearly 96.7 percent of ED nurses and 73.1 percent of non-ED nurses experienced workplace violence (Speroni et al., 2014). Nurses are at an increased risk for sustaining psychological and physical injuries within the hospital setting when caring for aggressive patients, and violent events in these settings are often unpredictable. There is no standardized process for nurses to assess for aggressive behaviors before patients act out violently.Aim: The purpose of this project was to standardize the assessment of aggressive behaviors in adult patients over the age of 18 with a history of violent behaviors or actively exhibiting aggression, provide earlier interventions to reduce assault rates against nurses, improve patient care, and promote a safe environment through the implementation of the Dynamic Appraisal of Situational Aggression (DASA) at a large Midwestern academic hospital.Methods: The strategy for this quality improvement (QI) project is a model evaluation using the Plan-Do-Study-Act (PDSA) cycle to develop a strategic plan to implement the DASA into nursing practice. The project took place over a 3-month timeframe on three inpatient progressive care units at a large Midwestern academic health system and the population of interest are nurses working on these units. Descriptive statistics were used for data analysis. Qualitative information was assessed using formative evaluation and round table discussions with nurses every month for feedback on the utility of the DASA.Results: There were 10 patients identified for aggressive behaviors and assessed using the DASA. Nurses reported that the DASA helped identify aggressive behaviors, allowing them to implement earlier interventions to de-escalate the risk of violence.Conclusions: The DASA offers a standardized approach to identifying and de-escalating aggressive behaviors to reduce the risk of violence against nurses. This project sets the foundation for implementing the DASA across inpatient acute care nursing units at an academic hospital.