Date of Conferral



Doctor of Nursing Practice (DNP)




Barbara Niedz


Violence in mental health care continues to be a problem. The incidence of violent episodes in healthcare settings with aggressive behavior of patients aimed at staff members or other patients is almost four times greater in healthcare than in other industries. Reducing violent episodes enhances the quality of care and improves safety for staff members and for patients. The project focused on development of a staff education program exploring the practice-focused question: Will this program effectively guide staff member approaches to mental health patients with challenging behaviors? The purpose of this project was to address the identified gap in practice in one mental health unit at a Florida correctional facility. A comprehensive literature review was completed using 30 sources from 2012-2017 and included peer-reviewed research and government resources to guide the development of this program, called TAPOUT. Sources of evidence emerged from a systematic review of the literature and an expert panel in mental health. Using the Delphi technique, all 5 panel members came to consensus after 2 rounds, agreeing to implement the TAPOUT program. The findings demonstrated the TAPOUT program may effectively guide staff member approaches to mental health patients with challenging behaviors and showed the benefits of using the TAPOUT program for reduction of violence. The DNP project has demonstrated TAPOUT can address the identified practice gap. The educational program's goal was to reduce violence and positively impact social change by providing staff members with tools to prevent and to deescalate emerging violent behaviors and episodes, preventing injury among staff members and patients alike.