Degree Name
Nursing Practice, DNP
Publication Date
2-24-2026
First Advisor
Sandra King
Second Advisor
Antiqua Smart
Abstract
Workplace violence is a global challenge, and nurses often encounter patient aggression. The purpose of this quality improvement project was to enhance the use of a behavioral assessment tool derived from the Brøset Violence Checklist and the Behavioral Emergency Response Team (BERT) to de-escalate workplace violence. This project aimed to improve behavioral assessment documentation and BERT use in a critical care unit by 30% within 5 weeks. Guided by the Donabedian Model theoretical framework and Lewin's Change Theory, the project employed a quasi-experimental, pretest-posttest design in an advanced heart failure unit with full-time nurses as participants. The Plan-Do-Study-Act (PDSA) framework guided implementation. The intervention included structured education on the behavioral assessment tool and BERT. Statistical analysis showed improvements following the intervention. Pre-intervention analysis showed that 60% of behavioral assessments were missed, with no BERT calls for patients exhibiting abusive behavior. Post-intervention data showed a substantial reduction in missed behavioral assessments (8%), with BERT activation in 5 of 9 patients (55.5%). The two proportions z-tests showed statistically significant findings in the pre- and post-intervention behavioral assessment documentation (z = -14.68, p < .001, 95% CI = [-.59, -.45]) and BERT utilization (z = -2.39, p < .017, 95% CI = [-.88, -.23]). Overall, this project underscores the importance of structured education in improving the use of a behavioral assessment tool and BERT to de-escalate workplace violence in an acute care setting, with wide applicability.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Sindhu, Joseph, "Quality Improvement Project: Use of the Behavioral Risk Assessment Tool to Enhance the Utilization of the Behavioral Emergency Response Team" (2026). Doctor of Nursing Practice Projects. 303.
https://arch.astate.edu/dnp-projects/303
