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.
Qualitative exploratory study using focus-group data.
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.
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.
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Lisa A. Wolf, Member, Pioneer Valley Chapter, is Director, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL
Cydne Perhats is Senior Associate, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL.
Altair M. Delao is Senior Associate, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL.
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.
Michael D. Moon, Member, San Antonio Chapter, is Associate Professor, University of the Incarnate Word, San Antonio, TX.
Kathleen Evanovich Zavotsky is Assistant Vice President at the Center for Professional Development, Innovation and Research, Robert Wood Johnson University Hospital, New Brunswick, NJ.
Published online: March 01, 2018
CE Earn Up to 6.5 Hours. See page 541.
© 2018 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.