Degree Name
Nursing Practice, DNP
Publication Date
9-29-2026
First Advisor
Sandy King
Second Advisor
Anthony Morgan
Abstract
Workplace violence remains a concern in psychiatric nursing, particularly when changes in patient behavior are not recognized early or communicated consistently. This quality improvement (QI) project was conducted at a psychiatric recovery center in Central Ohio after identifying a practice gap in aggression risk assessment and response. The purpose was to implement and evaluate a multicomponent aggression-management approach using the Brøset Violence Checklist (BVC), structured team huddles, and individualized aggression care plans. The aim was to improve nurse confidence (primary outcome) and reduce aggressive behavioral incidents (secondary outcome) over four weeks. Bandura’s Social Cognitive Theory and Lewin’s Change Theory guided the project, and the team used Plan-Do-Study-Act (PDSA) cycles. Twenty registered nurses and licensed practical nurses participated in a quantitative, one-group pretest-posttest project. Nurses completed an adapted five-item Confidence Scale (C-Scale) before and after implementation. Aggressive behavioral incidents were recorded during four baseline weeks and four implementation weeks. The mean C-Scale score increased from 16.00 (SD = 2.62) before implementation to 19.45 (SD = 1.96) afterward, a 3.45-point increase. The paired t test was statistically significant, t(19) = 14.04, p < .001, with a 95% confidence interval of 2.94 to 3.96 and a large effect size, Cohen’s d = 3.14. Aggressive incidents also decreased by 35.3%. Findings were interpreted in light of the one-group design, the short implementation period, and aggregate incident data. The intervention can be incorporated into routine psychiatric nursing practice, but continued monitoring is needed.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Amakulor, Grace, "Quality Improvement Project: Improving Nurse Confidence in Managing Patient Aggression Using the Brøset Violence Checklist and Team-Based Strategies" (2026). Doctor of Nursing Practice Projects. 379.
https://arch.astate.edu/dnp-projects/379
