Utility of the Dynamic Appraisal of Situational Aggression – Inpatient Version (DASA-IV) in an acute adult inpatient non-forensic psychiatric setting: A feasibility study

Abstract

Background

The Dynamic Appraisal of Situational Aggression – Inpatient Version (DASA-IV) is a brief violence risk assessment tool to evaluate imminent risk of aggression. There have been no previous studies to investigate its utility in an acute adult non-forensic psychiatric setting in Australia.

Objective

To examine the feasibility of DASA-IV implementation in an acute adult inpatient non-forensic psychiatric setting.

Methods

This study utilised a quasi-experimental design with pre- and post-testing. Subjective data from questionnaires administered to psychiatric staff on utility of DASA-IV and objective data on frequency of aggression incidents were collected.

Results

Staff reported higher confidence in deciding when medications, seclusion, and security and medical staff were required to manage aggression. DASA-IV was reported as valuable and easy to use. Lack of time and lack of DASA-IV training for non-regular nurses were barriers to implementation. Only the control unit had a statistically higher number of aggression incidents post-intervention.

Conclusions

DASA-IV is a feasible tool that improves staff confidence in managing aggression and reduces aggression incidents in an acute adult non-forensic inpatient psychiatric setting in a metropolitan tertiary public hospital. Its implementation may assist in aggression management in the acute adult non-forensic inpatient psychiatric setting.