Citation

DeSouza F, Bleich M. J. Nurs. Care Qual. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Lippincott Williams and Wilkins)

DOI

10.1097/NCQ.0000000000000713

PMID

37094582

Abstract

BACKGROUND: The impact of aggressive and violent behaviors directed toward staff in psychiatric facilities has layers of implications tied to recruitment and retention, cost, quality and safety. LOCAL PROBLEM: Increased patient aggressive behaviors contributed to staff dissatisfaction and high turnover rates, triggering an analysis of current aggression management approaches.

METHODS: The Plan-Do-Study-Act quality improvement method was used for this project. INTERVENTIONS: The Dynamic Appraisal of Situational Aggression (DASA) risk assessment tool was implemented.

RESULTS: Daily aggression risk identification increased by 69%, and aggressive incidents toward staff and patients decreased by 64% and 28%, respectively, when the tool was completed more consistently. Surveys revealed acceptance of the tool by nurses.

CONCLUSIONS: Quality improvement statistical tools supported evidence-based strategies. A risk for aggression assessment laid the foundations for implementing strategies for reducing aggression and violence.

Language: en