Date of Graduation

Summer 8-15-2016

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Ellena Capella

Abstract

Violence towards healthcare workers in acute care settings, particularly mental health units is increasing nationwide, causing safety and financial concerns for health care organizations. Efforts were made to decrease assaults directed towards healthcare staff on a twenty five bed adult mental health unit in a large academic university hospital. The aim of the project was to decrease assaults by twenty-five percent in six months after implementation of a Violence Risk Assessment (VRA) tool. The ultimate goal was to maintain assault rates below NDNQI. Assaults on the unit for the fourth quarter of 2015 were 2.92, NDNQI 2.05. Assaults with injury were 2.43, NDNQI 0.75. A literature review was performed to ascertain valid and reliable tools in predicting assaultive behavior which resulted in three VRA tools with high predictive value: the Broset Violence Checklist (BVC), Dynamic Appraisal of Situational Aggression (DASA), and Modified Overt Aggression Scale (MOAS). Each tool was piloted on the unit for two weeks followed by a survey to staff regarding their choice of tool based on risk assessment, ease of use, and acceptability (Appendix A). The DASA (Appendix B) was chosen by the staff and approved by the Nursing Steering Committee. Next steps include implementing the DASA tool in the electronic health record with follow up metrics to determine its effectiveness in identifying and decreasing assault potential. Recommendations include implementing EBP interventions to prevent violence for patients identified as assault risk.

Comments

Implementation of Violence Risk Assessment tool using the electronic health record on an in-patient psychiatric unit in an large academic health system

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