Author

Alan LeFollow

Date of Graduation

Fall 12-17-2021

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

College/School

School of Nursing and Health Professions

Department/Program

Nursing

Program

Psychiatric Mental Health Nurse Practitioner

First Advisor

Dr. Trinette Radasa

Second Advisor

Dr. Alexa Curtis

Abstract

Background: Patient suicide is a serious safety issue, especially in mental health settings since suicides disproportionately affect psychiatric patients. Environmental hazards are a primary contributing factor in patient suicide cases.

Problem: Mental health staff may lack tools and training to perform proper environmental risk assessments, which is the case at a psychiatric crisis residential center in northern California that utilized no environmental risk assessment tool.

Methods: An environmental risk assessment tool was implemented at the site for four months to increase staff confidence, ability to identify hazards and decrease risk of patient suicides.

Interventions: The Suicide and Self-Injury Patient Checklist (SSIPCL) was implemented, which is an evidence-based tool that has demonstrated efficacy in the standardized identification of hazards and reduction of patient suicide rates.

Measures: Primary outcome measures observed pre and post implementation include patient suicide attempt rate (indicated by 5150 DTS [danger to self] holds placed at the site per month or case of suicidal ideation [SI]). Staff confidence scores were measured in regards to perceived site patient safety and ability to identify environmental hazards.

Results: Patient suicide attempt rate (in holds per month) did not change after implementation, remaining the same at 0.25. For holds placed per case of SI, there was a decrease of 66% (1 to 0.33). There was a marked improvement in staff satisfaction scores.

Conclusions: The SSIPCL can be effective in reducing risk of patient suicide and increasing staff satisfaction in a residential setting, but more research is needed over a longer time span.

Key words: environment, suicide prevention, patient suicide, psychiatric, hazard

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