Utilizing an Educational Intervention to Increase Psychiatric Staff Knowledge on Aggression Screening and Implementation

Abstract

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to assess the effectiveness of an educational intervention designed to enhance psychiatric staff knowledge and willingness to implement an evidence-based aggression screening tool, the Dynamic Appraisal of Situational Aggression (DASA), during patient admissions. The project also aimed to identify barriers and facilitators to the integration of structured aggression screening into clinical practice.Background: Aggression in psychiatric settings posed significant risks to patient and staff safety. Evidence-based tools like the DASA had been shown to improve the identification of aggression risk and promote proactive interventions. Despite these benefits, implementation was often hindered by knowledge gaps, resistance to change, and systemic barriers. Addressing these challenges through targeted educational initiatives improved staff preparedness and fostered safer environments. Methods: A single-group pretest-posttest design was utilized to evaluate the impact of the educational intervention on staff knowledge of the DASA tool. The intervention included a structured presentation emphasizing the operational use of the tool and the importance of mitigating personal bias. Due to limited staff availability, only the director of risk management participated in both the pretest and posttest. Quantitative data from knowledge assessments were analyzed, and qualitative feedback from the participant was thematically analyzed to identify implementation barriers and perceptions. Results: The participant demonstrated consistent pretest and posttest scores of 8/10, indicating a high baseline knowledge level but no measurable improvement. Qualitative data collected revealed key themes, including confusion regarding tool sequencing, corporate barriers to implementation, and the perceived feasibility of the DASA tool when adequately supported by leadership and training. These findings emphasized the need for systemic changes and enhanced educational efforts. Conclusions: This project highlighted the potential of targeted educational interventions to improve aggression screening practices in psychiatric settings. While limited by sample size, the findings underscored the importance of leadership engagement, ongoing training, and policy adjustments to facilitate the integration of structured tools like the DASA. Future efforts should focus on addressing systemic barriers, expanding training initiatives, and conducting multi-site evaluations to validate these findings and enhance scalability.