Reducing Suicide in Emergency Departments Research Paper

Pages: 12 (3683 words)  ·  Bibliography Sources: 9  ·  File: .docx  ·  Level: Master's  ·  Topic: Nursing  ·  Written: November 10, 2019

SAMPLE EXCERPT . . .
It would be helpful for them to know that the Safety Planning Intervention has been applied and this should be recorded in the patient’s medical record and shared with the mental health provider upon request. Family and friends of the patient are also stakeholders as they will be part of the patient’s support network and will be “on-call” so to speak whenever the patient is facing a suicidal crisis and needs support. The primary focus on implementing this strategy is, however, the care providers of the emergency department at Mercy Health.

Education Required by Stakeholders

The care providers in the emergency department at Mercy Health would require basic training in how to conduct the Safety Planning Intervention for persons who present to the ED with suicide-related issues. Training can be conducted in a simple manner, according to the developers of the intervention. The training steps are:
  1. reading the safety plan manual by Stanley & Brown (2008),
  2. reviewing the brief instructions (Stanley & Brown, 2008) and the safety planning form;
  3. attending training in which the intervention, its rationale, and evidence base are described; and
  4. conducting role-plays to practice implementing the intervention (Safety Planning Intervention, 2019).

Resources Needed

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The resources needed for this training are the safety plan manual, which can be obtained from http://www.suicidesafetyplan.com/Training.html. A training room and practice intervention session will be required in which trainees get to role play implementing and receiving the intervention. This is a form of simulation that gives the care providers extra assistance in learning how to conduct the intervention. The trainer, presumably the head nurse or instructor nurse at the ED, will require the rationale and evidence base provided by Stanley et al. (2018) to assist with the instruction phase of the training.

Timelines for Planning, Action, and Evaluation

Research Paper on Reducing Suicide in Emergency Departments Assignment

Planning the training should not take long at all. Putting in the request for the Safety Plan Form will at http://www.suicidesafetyplan.com/Training.html will take a matter of moments and the necessary materials can be shipped quickly once the order is put in. Nurses will have to schedule training and it is reasonable, given the size of the ED staff, that training could be concluded over the span of 3 weeks. The necessary reading materials could be delivered ahead of time so that trainees are read-up on the intervention before attending the initial first session. Scheduling and planning the training session, which can be a one-time, hour-long class should not take any more than a week. Providing the training should take at most three weeks to get all nurses into the class. Initial evaluation can be conducted at the end of each training session, so this step would be lumped in with the training preparation. Post-intervention evaluation should continue for two years to determine whether there has been a drop-off rate in emergency calls for self-harm from previously admitted patients at the ED.

Measurable Outcomes

Since the goal of this intervention is to reduce the risk of suicide for patients who present to the ED for self-harm related issues, the only valid measure would be to assess the rate of suicide for these same patients over the course of two years. Since 80% of persons who commit suicide presented themselves to the emergency room for self-harm issues at some point in the year prior to their suicide (Chaterjee, 2018), it stands to reason that the most effective measure for this intervention would be to assess whether the rate of suicide has decreased, increased or stayed the same over the course of two years following the implementation of this intervention at the local area ED.

The rate of suicide for patients who presented in years prior should be obtained, first, however as a baseline. This should go back at least ten or fifteen years to show what the trend line is. Following the intervention, a new record should be kept on all patients who present for suicide-related issues to the ED. Once they have presented, their health recorded should be monitored for measuring purposes. Individuals may need to sign a consent form for this purpose when receiving the intervention at the ED so that there are no ethical conflicts in the hospital continuing to monitor the patient’s health record over the course of the next two years.

Collecting and Analyzing Data

Data would be collected using a basic patient portal algorithm that links the patient’s medical record, upon receiving the informed consent of the patient, to the hospital's monitoring database so that anytime there is an update to the record it is included in the database. If the patient is deceased at any point over the following two years, the data on the cause of death is linked to the database as well.

The analysis would be conducted at the end of the first year and again at the end of the second year. This would provide a statistical percentage of patient-suicide rate similar to what Stanley et al. (2018) did for their longitudinal study when they tested their intervention on 1200 patients over the course of several years following the intervention to see what the success rate was based upon the decrease in suicide rates per patients who received the intervention. Data would be analyzed by conducting a simple percentage analysis and comparing it to the baseline and trend line that existed prior to the intervention.

Using Data to Complete the Quality Improvement Feedback Loop

A simpler and likely just as an effective measure could be to survey patients who presented to the ED and received the intervention. This would require no informed consent and patients could simply be contacted based on the contact information they provide at the time of presenting. Follow-up phone calls every quarter or four times a year could provide data on how the patient is doing mental-health wise and whether the patient has been receiving the long-term mental health care recommended at the time of presenting at the ED.

The survey could include questions about whether the patient found the intervention to be satisfactory, whether it assisted the patient with confronting future suicide-related crises that occurred following the ED visit, and whether the patient has been receiving mental health care since then. This would provide quality feedback for the hospital that could support the quantitative data collected over the course of the following years to assess whether there has been a decline in the suicide rate of patients presenting for suicide ideation at the ED.

Summary of the Role of the Risk Manager in This Project

The role of the risk manager in this project is to identify the risks at the hospital that need to be addressed. As only one risk can be addressed at a time, the risk manager must look at every department and be well-versed in the latest findings in evidence-based practice. The risk of… [END OF PREVIEW] . . . READ MORE

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