Date of Graduation

Fall 12-11-2020

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Executive Leader DNP

First Advisor

Dr. Sara Horton-Deutsch

Second Advisor

Dr. Elena Capella


Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change.

Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression in non-emergency department and non-behavioral health settings (e.g., medical-surgical, telemetry, and step-down acute care units) has presented a unique knowledge gap for healthcare staff not traditionally trained to provide care for patients who present with aggression and/or behavioral crises.

Interventions: The project interventions focused on quantitative and qualitative evidence to develop, implement, and evaluate an integrated WPV prevention staff education course, to improve staff knowledge about WPV prevention and improve staff attitudes about managing care for aggressive patients. The course integrated organizational policies and protocols for violence risk assessment and behavioral emergency response codes.

Outcome Measures: Outcomes were measured by pre- and post-intervention surveys, data analyses, staff education evaluation forms, and anecdotal findings from participant feedback. The outcomes measured showed an improvement in staff knowledge(29.4%, n = 8) and attitudes (14.7%, n = 8) after the WPV prevention education course. The project was successfully implemented in a major healthcare care system in San Diego, California, and provided valuable guidance in the development of integrated frontline nursing education as part of a comprehensive WPV prevention program.

Keywords: violence, workplace violence, workplace violence prevention program, crisis intervention, behavioral distress, nursing, psychiatric nursing, nursing leadership, mental health, behavioral health, healthcare