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BACKGROUND The impact of aggressive and violent behaviors directed toward staff in psychiatric facilities has layers of implications tied to recruitment and retention, cost, quality and safety. LOCAL PROBLEM Increased patient aggressive behaviors contributed to staff dissatisfaction and high turnover rates, triggering an analysis of current aggression management approaches. METHODS The Plan-Do-Study-Act quality improvement method was used for this project. INTERVENTIONS The Dynamic Appraisal of Situational Aggression (DASA) risk assessment tool was implemented. RESULTS Daily aggression risk identification increased by 69%, and aggressive incidents toward staff and patients decreased by 64% and 28%, respectively, when the tool was completed more consistently. Surveys revealed acceptance of the tool by nurses. CONCLUSIONS Quality improvement statistical tools supported evidence-based strategies. A risk for aggression assessment laid the foundations for implementing strategies for reducing aggression and violence.