Date of Award


Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Joanne D. Iennaco


Management of violent acts by patients and visitors in the ambulatory care environment is an important issue that research has not addressed. This report utilizes research conducted in inpatient healthcare settings regarding violence, patient and visitor risk factors for violence, staff characteristics that increase the likelihood of victimization, and the impact violent acts have on staff morale as well as impacts on patients’ perceived quality of care. Identification of interventions to de-escalate aggressive patients and visitors from research conducted within the inpatient environment is synthesized for evaluation of its application to ambulatory care. Feedback regarding these risk factors from clinic staff in the ambulatory care environment and content experts is analyzed to further develop interventions to promote staff safety specific to the ambulatory care environment.

Open Access

This Article is Open Access