Title : Predict, prevent, protect: Implementing DASA YV to reduce aggression in child and adolescent inpatient psychiatry.
Abstract:
Workplace violence and patient aggression in child and adolescent inpatient behavioural health settings continue to rise, placing both patients and staff at risk and contributing to burnout, injury, and inconsistent care. This content is relevant to bedside nurses, who are often the first to recognize subtle changes in behaviour but may lack standardized tools to guide early intervention. The implementation of the Dynamic Appraisal of Situational Aggression–Youth Version (DASA-YV) addresses this gap by providing a brief, evidence-informed, structured approach to assessing short-term risk for aggression and supporting proactive, individualized care planning. Research supports the use of structured risk assessment tools like DASA-YV to improve prediction of imminent aggression and enhance team communication, ultimately reducing incidents of violence and the use of restrictive interventions such as seclusion and restraint. In practice, integrating DASA-YV into daily nursing workflows, combined with staff education on trauma-informed care and de-escalation techniques, has been associated with increased staff confidence, improved identification of early warning signs, and more timely, preventive interventions. Embedding the tool into the electronic health record further strengthens interdisciplinary communication and consistency in care. Nursing implications include enhanced clinical decision-making, improved safety for both patients and staff, and alignment with regulatory and ethical priorities to minimize harm and reduce coercive practices. This approach reinforces the critical role of nurses as leaders in creating therapeutic, trauma-informed environments while advancing evidence-based practice in behavioural health settings.
