Date of Award


Document Type

Restricted Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)




Violence has increased across America impacting persons in a variety of workplaces, including nurses in hospitals and ambulatory care. Workplace violence negatively impacts healthcare teams and includes physical and verbal abuse, which occurs in a clinic, over the telephone, or through online secure messaging. Few resources exist to help nurses and all health care staff mitigate violence in health care settings. Because nurses often feel unprepared for addressing violence, guidance is needed from nursing leadership. In a large Midwest Academic Tertiary Medical Center a nurse manager formed a small multidisciplinary workgroup to address workplace violence and staff safety in an HIV clinic. Through a series of interventions designed to help staff recognize patterns of interaction within the clinic and in their clients’ lives that potentially may lead to violent behavior, staff are feeling more empowered to moderate or prevent violence and to create a safer workplace. The project is guided by Margaret Newman’s Theory of Health as Expanding Consciousness and the concept of pattern identification. Staff education for violence prevention and de-escalation, the development of process guidelines for dealing with violent behavior in the clinic and via telehealth, and a procedure for creating a staff huddle, are all key interventions that promote pattern identification and the creation of a healthier, safer work environment at the HIV clinic. This project implements interventions which empower a multidisciplinary team at the HIV clinic to successfully care for clients exhibiting violent behaviors and increase team communication while maintaining client and staff safety through education, tools, and standardized processes.


SC 11.DNP.2019.Frahm.M