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IDENTIFY PATIENTS AT RISK FOR SUICIDE. NPSG # 15. Identifying Patients at Risk for Suicide. Why is this important? Suicide of a patient while in a hospital setting is a frequently reported sentinel event - PowerPoint PPT Presentation
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IDENTIFY PATIENTS AT RISK FOR
SUICIDE
NPSG # 15
IDENTIFYING PATIENTS AT RISK IDENTIFYING PATIENTS AT RISK FOR SUICIDEFOR SUICIDE
Why is this important?
• Suicide of a patient while in a hospital setting is a frequently reported sentinel event
• Identification of individual at risk for suicide while under the care of or following discharge from a hospital is an important step in protecting at risk individuals
ELEMENTS OF PERFORMANCEELEMENTS OF PERFORMANCE1. Risk Assessment
2. Address Safety Needs
3. Suicide prevention upon discharge
RISK ASSESSMENT
MEDICAL MEDICAL FLOORSFLOORS
RISK ASSESSMENT SAD PERSONS Suicide Risk Assessment
completed upon admission and as indicated based on clinical assessment
SCORED TO DETERMINE RISK AND INTERVENTION 1-2 Low 3-6 Moderate (communicate to MD) 7-10 High (notify MD for additional orders)
EMERGENCY DEPARTMENTEMERGENCY DEPARTMENT
RISK ASSESSMENT• ED Suicide Screening Tool
the patient will be triaged by the RN
• Scored to determine risk and intervention 1-2 Low Risk (monitor patient) 3-6 Moderate (communicate to MD) 7-10 High (notify MD & charge nurse)
BEHAVIORAL HEALTH BEHAVIORAL HEALTH SERVICESSERVICES
RISK ASSESSMENT Suicide/Self Harm Assessment
completed upon admission and as indicated based on clinical assessment
SCORED TO DETERMINE RISK AND INTERVENTION 0-12 Low (q15 minutes) 12-16 Moderate (L.O.S, notify MD) 16-20 High (1:1, notify MD)
Talking or writing about death, dying or suicide
Threatening to hurt or kill self Hopelessness Increasing alcohol or drug abuse Withdrawing from friends, family or society No reason for living, no sense of purpose in
life
A previous suicide attempt Extreme mood swings; very depressed
followed by happy episodes Drastic changes in habits, friends, or
appearance Giving away prize possessions
ADDRESSING SAFETY NEEDS
MEDICAL FLOORSMEDICAL FLOORS
Patients considered at risk for suicide will receive continuous 24-hr observation
Belongings/valuables placed in plastic bag Dietary department to use paper/plastic goods Observation maintained until attending MD
discontinues order
EMERGENCY DEPARTMENTEMERGENCY DEPARTMENT
Patients considered at risk for suicide will receive continuous 24-hr observation
BHS notified to complete intake assessment• Ultimate goal is to detain patient until the 5150
determination or patient is no longer a risk Patient will wear paper gown Belongings/valuables placed in plastic bag for
safe keeping Dietary department to use paper/plastic goods Family members or significant others not
allowed to visit while on 5150 or 5250
BEHAVIORAL HEALTH BEHAVIORAL HEALTH SERVICESSERVICES• Patients considered at risk for suicide will receive continuous
24-hr observation.• MD order for LOS or 1:1
Must be renewed every 24hrs Educate patient regarding observation
• LOS (Line-of-Sight) Patient is able to contract for safety Maintain visibility at all times Staff cannot have additional assignments
• 1:1 Patient cannot contract for safety Maintain visibility One arm length from patient at all times Document on patient every 2 hours Staff cannot have additional assignments
GENERAL SUICIDE GENERAL SUICIDE PRECAUTIONSPRECAUTIONS
• Patients considered at risk for suicide will receive continuous 24-hr observation Family members or significant others cannot be used
as sitters Must have continuous unobstructed view of the
patient, including during toileting The observer is not to have reading material, accept
phone calls, or talk with other staff members Maintain safe environment and free of hazards
Medical floors/ED: be aware of telephone cords, curtain controls, shoe laces, pajama strings, IV tubings, plastic bags, wire hangers, and belts
DOCUMENTATIONDOCUMENTATION
• Document thoroughly the need for suicide precautions
precipitating event interventions used patient response to interventions efforts to maintain safe environment
SUICIDE PREVENTION UPON DISCHARGE
BEHAVIORAL HEALTH BEHAVIORAL HEALTH SERVICES/SERVICES/MEDICAL FLOORSMEDICAL FLOORS
• Suicide prevention information (Crisis Hotline) is auto-populated on your discharge instructions