Improving Suicidal Ideation Screening and Suicide Prevention Strategies on Adult Nonbehavioral Health Units.

IF 0.2 Q4 NURSING Journal of Doctoral Nursing Practice Pub Date : 2021-06-09 DOI:10.1891/JDNP-D-20-00049
Anne C Lindstrom, Melinda Earle
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Abstract

Background: Suicide is a risk in hospitalized patients within and outside of behavioral health units. Williams et al. (2018). Incidence and method of suicide in hospitals in the United States. Williams et al. (2018), suicides occur annually in hospitals, 14%-26% of occurrences outside of a behavioral health unit.

Objectives: The purpose of this project was to improve compliance with universal patient suicide ideation screening and targeted actions for patients screening positive admitted to nonbehavioral health units.

Methods: Electronic medical record (EMR) changes to support screening and targeted patient safety measure documentation were implemented. Nursing education was provided to support these changes. Pre- and postassessments were used to measure knowledge gained from the education. A compliance report was generated from the EMR to measure compliance with universal screening and patient safety measures.

Results: In a 4-month period, screening compliance improved by 20.6%, bedside safety companion use was 100%, suicide precautions, documentation 82.5%, and a behavioral health social work note documented 76% of the time.

Conclusions: Universal screening improvement is feasible and has the potential to improve patient safety. Implementation should be considered across health care organizations.

Implications for nursing: Providing nursing education and easier EMR workflows for nursing documentation of suicide screening and prevention strategies improves patient safety.

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改进成人非行为健康病房的自杀意念筛查和自杀预防策略。
背景:自杀是行为健康科室内外住院患者的一种风险。Williams 等人(2018 年)。美国医院中自杀的发生率和方式。Williams et al. (2018),医院每年都会发生自杀事件,14%-26%的自杀事件发生在行为健康科室之外。Objectives:本项目旨在提高普遍患者自杀意念筛查的依从性,并对非行为健康科室收治的筛查阳性患者采取有针对性的行动:方法:对电子病历(EMR)进行修改,以支持筛查和有针对性的患者安全措施记录。为支持这些改变,还开展了护理教育。使用事前和事后评估来衡量从教育中获得的知识。通过 EMR 生成合规性报告,以衡量普遍筛查和患者安全措施的合规性:在 4 个月的时间里,筛查合规率提高了 20.6%,床旁安全伴侣的使用率达到 100%,自杀预防措施、文件记录率达到 82.5%,行为健康社会工作记录率达到 76%:结论:普遍筛查的改进是可行的,并有可能提高患者安全。结论:普遍筛查的改进是可行的,并有可能改善患者的安全,各医疗机构都应考虑实施:为自杀筛查和预防策略的护理记录提供护理教育和更简便的 EMR 工作流程可提高患者安全。
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