The aim of this study was to promote evidence-based violence risk assessment in 
inpatient psychiatric care. The study was an implementation study with three phases 
utilizing a mixed-method approach. The Ottawa Model of Research Use was used as 
a theoretical framework. The setting was three closed adults’ psychiatric wards and 
two associations for families of mental health patients. The violence risk assessment 
intervention implemented was the Dynamic Appraisal of Situational Aggression. 
First, assessment of key elements for implementation was explored from the 
perspectives of nursing staff, relatives of mental health patients, and the practice 
environment. In addition, the intervention was specified. Second, implementation 
was monitored on the wards: barriers and facilitators for the implementation, 
knowledge transfer strategies, adaptation and use of the intervention were explored. 
Third, evaluation of outcomes of the intervention implemented was done from 
perspectives of nursing staff and mental health inpatients. The feasibility of the 
intervention was explored. 
Assessment of key elements revealed the views of nursing staffs and relatives of 
mental health patients on the complexity of violent events in psychiatric care and 
identified common needs for the development of violence prevention and 
management. Monitoring the implementation yielded knowledge about intervention 
implementation in the clinical practice setting and its challenges. Evaluation of 
implementation outcomes revealed mixed perceptions of violence risk assessment 
intervention and the feasibility criteria set were not fully met. 
This dissertation provides new insights which can be utilized when implementing 
novel methods to prevent and manage patient violence in more user-centered 
manners. On basis of the study results, patient involvement in short-term risk 
assessment can be seen as a new, promising working method in psychiatric inpatient 
care. Thus, to confirm this finding, more research is needed. 
Keywords: psychiatric nursing, violence risk assessment, implementation, user- 
centeredness