Enhancing risk assessment and nursing interventions to prevent aggression and reduce the use of restrictive interventions in forensic mental health units

The ultimate aim of this thesis was to test whether structuring nursing interventions and linking them to the Dynamic Appraisal of Situational Aggression (DASA) would lead to a reduction in aggression and restrictive interventions in a forensic mental health unit for female patients. Initial studies showed that the DASA has modest predictive validity for both males and females, although these is a need to revise the risk bands, and that some nursing interventions may aggravate patients, leading to an increase rather than decrease in aggression. These results were used to develop an Aggression Prevention Protocol, which was embedded in an electronic application of the DASA. The introduction of this APP resulted in a lessening of restrictive interventions, administration of PRN medication, and verbal aggression, with an increase in documented nursing interventions.