Date of Doctor of Nursing Practice Project Completion
2026
Faculty Advisor
Dr. Shannon Warren
Abstract
Purpose: This quality improvement project evaluated whether implementation of the Dynamic Appraisal of Situational Aggression (DASA) tool reduced aggressive incidents compared with unstructured clinical judgment.
Background: Workplace violence is a persistent safety concern in inpatient psychiatric settings, contributing to staff injury, burnout, and compromised patient care.
Methods: Guided by Lewin’s Change Model, a pre–post intervention design was implemented over eight weeks on a 23-bed male forensic psychiatric unit. Registered nurses received standardized education and completed daily DASA assessments for all admitted patients. Data were collected from incident reports, DASA scores, and pre- and post-intervention nurse surveys. Descriptive statistics were used to examine changes in aggression, seclusion, restraint use, and staff perceptions.
Results: Following implementation, total aggression-related incidents decreased by 42.1%. Verbal aggression declined by 38.5%, physical aggression by 44.4%, and self-injury by 66.7%. Seclusion events were reduced by 50%, with a 65% decrease in total seclusion minutes. Nurses reported increased comfort assessing aggression risk, decreased reliance on clinical judgment alone, and greater confidence in structured violence risk assessment.
Implications for Practice: Findings support DASA as a feasible, reliable, and effective tool for early identification of imminent aggression. Incorporating structured violence risk assessment into routine nursing practice may reduce coercive interventions, improve staff confidence, and enhance patient and workplace safety. Sustainability may be achieved through ongoing education, leadership support, and integration into standard workflows, with potential for spread to additional psychiatric units. Future evaluation should examine long-term outcomes, cost-effectiveness, and applicability across diverse inpatient psychiatric populations and clinical care settings.
Keywords
Workplace violence, DASA, Inpatient psychiatric setting, Violence risk assessment, Aggression
Recommended Citation
Doose J. Onarinde, "Using the Dynamic Appraisal of Situation Aggression (DASA) Tool in an Inpatient Psychiatric Unit" (2026). Doctor of Nursing Practice Final Project Abstract. 166.
https://digitalcommons.library.tmc.edu/dnp_abstract/166