{"title":"A Quality Improvement Approach to Violence Reduction: Standardizing the Risk Identification Process.","authors":"Fabio DeSouza, Michael Bleich","doi":"10.1097/NCQ.0000000000000713","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Local problem: </strong>Increased patient aggressive behaviors contributed to staff dissatisfaction and high turnover rates, triggering an analysis of current aggression management approaches.</p><p><strong>Methods: </strong>The Plan-Do-Study-Act quality improvement method was used for this project.</p><p><strong>Interventions: </strong>The Dynamic Appraisal of Situational Aggression (DASA) risk assessment tool was implemented.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Quality improvement statistical tools supported evidence-based strategies. A risk for aggression assessment laid the foundations for implementing strategies for reducing aggression and violence.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of nursing care quality","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/NCQ.0000000000000713","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/20 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
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.
期刊介绍:
Journal of Nursing Care Quality (JNCQ) is a peer-reviewed journal that provides practicing nurses as well as nurses who have leadership roles in nursing care quality programs with useful information regarding the application of quality principles and concepts in the practice setting. The journal offers a forum for the scholarly discussion of “real world” implementation of quality activities.