Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Maureen Rauschhuber


Background and Significance. Agitation is a significant concern in psychiatric units. If not detected early, agitated individuals are at high risk for becoming aggressive and violent, potentially causing harm to themselves, hospital staff, and property. The Psychiatric Emergency Services unit receives agitated and violent patients with psychiatric illnesses and substance use disorders. Purpose/Goal/Objectives. This quality improvement project aimed to implement a treatment protocol using the Broset Violence Checklist (BVC) to promote the early identification and management of potential for patient violence and aggression. Methods/Key Activities. Staff education for the nurses and providers on assessing patients at risk for aggression and violence and implementing the algorithm of the BVC with a treatment protocol was conducted on-the day and night shifts for ten weeks. Results/Project Outcomes. One hundred fifty-two adult psychiatric patients aged 18-54 years were screened for potential violence using the BVC with 97% (n = 147) upon admission, 91% (n = 138) every 4 hours in the first 24 hours, and 86% (n = 130) every shift until discharge. The treatment protocol was utilized in 104 (68%) patients, where 23 (15%) required intramuscular medications, and two (1.3%) required physical restraints. Implications for Practice. With early recognition of the risk for violence, timely interventions can be applied without waiting for the patient to be severely agitated or violent.