Abstract
Introduction
Screening for suicidality is a critical nursing function at the initial ED encounter.
Suicide is the tenth leading cause of death in the United States, and a substantial
percentage of people who die by suicide present for health care in the year before
their deaths. The emergency department provides health care professionals with a critical
opportunity to identify patients at risk for suicide and intervene appropriately.
Methods
Qualitative exploratory study using focus-group data.
Findings
Effective and accurate suicidality assessment occurs not by asking a single question
but also with the assessment of patient behaviors and presentation (appearance, hygiene,
etc). When emergency nurses suspected occult suicidality, additional actions (finding
private space, keeping patients safe, and passing on information), took priority.
Discussion
The Joint Commission recommends using clinical judgment tools for the final determination
of safety for a patient at suspected risk of suicide, as research findings suggest
that a screening tool can identify persons at risk for suicide more reliably than
a clinician’s personal judgment. Our participants report that when they assessed suicide
risk at triage, it was usually by asking a single question such as “Do you have thoughts
or plans to harm yourself?” and they expressed concern about the effectiveness of
doing so. Participants described their efforts to improve suicide screening across
the duration of the patient’s ED stay through an iterative process of assessment that
included further probing and eliciting, evaluating, and reacting to the patient’s
response.
Contribution to Emergency Nursing Practice
- •Screening for suicidality is a critical function of triage nursing.
- •Screening is a process that involves recognition and interpretation of verbal and nonverbal cues.
- •Future efforts to improve triage assessment of suicide risk should include screening tools that are deployed continuously through the ED visit.
Keywords
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Biography
Lisa A. Wolf, Member, Pioneer Valley Chapter, is Director, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL
Biography
Cydne Perhats is Senior Associate, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL.
Biography
Altair M. Delao is Senior Associate, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL.
Biography
Paul R. Clark, Member, Kentuckiana Chapter, is Assistant Professor, University of Louisville School of Nursing and System Educator, Norton Healthcare Institute for Nursing, Louisville, KY.
Biography
Michael D. Moon, Member, San Antonio Chapter, is Associate Professor, University of the Incarnate Word, San Antonio, TX.
Biography
Kathleen Evanovich Zavotsky is Assistant Vice President at the Center for Professional Development, Innovation and Research, Robert Wood Johnson University Hospital, New Brunswick, NJ.
Article info
Publication history
Published online: March 01, 2018
Footnotes
CE Earn Up to 6.5 Hours. See page 541.
Identification
Copyright
© 2018 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
