Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Nanette Hoerr


Doctor of Nursing Practice


Violence within mental health units is a severe and increasing problem that affects staff, patients, and the health care setting in general. Nurses often rely on unstructured clinical judgment (UCJ) to predict violent episodes rather than empirically-derived, structured risk assessment instruments. Structured risk assessment tools are more accurate than UCJ in predicting risk for imminent aggression and reducing restrictive practices, including seclusion. This project implemented the DASA (Dynamic Appraisal of Situational Aggression) to identify risk for aggression or violence. The population included 50 registered nurses who worked in an inpatient, adult mental health unit in an urban setting in the Midwest. The nurses received education about the use of the DASA via a PowerPoint. The project team used the Plan-Do-Study-Act cycle to identify needed changes to the initial plan, modify the intervention, and act on findings. The project findings demonstrated that the DASA was a useful tool and that the nurses flt that routine screening for violence using the DASA enabled them to decrease the use of restraint and seclusion by identifying those at risk for aggression before an event occurred.