- 作者：Lisa M. Horowitz ; Ph.D. ; M.P.H.a ; horowitzl@mail.nih.gov ; Deborah Snyder ; M.S.W.a ; Erica Ludi ; B.S.a ; Donald L. Rosenstein ; M.D.d ; Julie Kohn-Godbout ; M.S.N. ; R.N. ; PMHCNS-B.C.b ; Laura Lee ; R.N. ; B.S.N.b ; Tannia Cartledge ; R.N. ; M.S.b ; Adrienne Farrar ; M.S.W. ; Ph.D.c ; Maryland Pao ; M.D.a
- 刊名：Psychosomatics
- 出版年：2013
- 出版时间：May-June, 2013
- 年：2013
- 卷：54
- 期：3
- 页码：239-247
- 全文大小：361 K
Background
Suicide in hospital settings is a frequently reported sentinel event to the Joint Commission (JC). Since 1995, over 1,000 inpatient deaths by suicide have been reported to the JC; 25 % occurred in non-behavioral health settings. Lack of proper ¡°assessment¡± was the leading root cause for 80 % of hospital suicides. This paper describes the ¡°Ask Suicide-Screening Questions to Everyone in Medical Settings (asQ'em)¡± Quality Improvement Project. We aimed to pilot a suicide screening tool and determine feasibility of screening in terms of prevalence, impact on unit workflow, impact on mental health resources, and patient/nurse acceptance.Methods
We piloted the asQ'em two-item screening instrument that assesses suicidal thoughts and behaviors, designed specifically for nurses to administer to medical patients. Educational in-services were conducted. A convenience sample of adult patients, 18 years or older, from three selected inpatient units in the National Institutes of Health Clinical Center, participated.
Results
A total of 331 patients were screened; 13 (4 % ) patients screened ¡°positive¡± for suicide risk and received further evaluation. No patient had acute suicidal thoughts or required an observational monitor. Screening took approximately 2 minutes; 87 % of patients reported feeling comfortable with screening; 81 % of patients, 75 % of nurses, and 100 % of social workers agreed that all patients in hospitals should be screened for suicide risk.
Discussion
Nurses can feasibly screen hospitalized medical/surgical patients for suicide risk with a two-item screening instrument. Patients, nurses, and social workers rated their experience of screening as positive and supported the idea of universal suicide screening in the hospital.