Date of Award
Doctor of Nursing Practice (DNP)
Dr Sheri Jacobson, PhD, RN
Dr Rebekah L. Powers, DNP, RN-BC, CMSRN, CSPHA, CHTS-CP
Practice Problem: Suicide is a public health condition that affects people globally. The increased suicidal behaviors of patients in a medical-surgical unit demanded an effective screening protocol to identify high-risk patients.
PICOT: In patients 18 years and older on a medical-surgical unit, does the implementation of the Columbia Suicide Severity Rating Scale (C-SSRS) tool and application of a Safety Bundle of Best Practices (SBBP) increase early identification of suicide risk with decreased patient self-harm behaviors, compared to the current standard practice of no assessment tool or safety bundle of best practices within 12 weeks?
Evidence: Ten studies served as evidence that assessment of early suicidal-risk behaviors decreased patient self-harm. The evidence supported the implementation of the C-SSRS tool and application of the Safety Bundle of Best Practices for the project intervention.
Intervention: The intervention consisted of three phases (pre-intervention, intervention, and post-intervention): a) patients were screened with the Columbia-Suicide Severity Rating Scale (C-SSRS); b) suicidal patients were managed with Collaborative Assessment and Management of Suicidality (CAMS); and c) a Safety Plan Intervention (SPI) was employed to manage suicidal behaviors.
Outcome: At the start of the assessment period, pre-intervention data yielded a C-SSRS risk score mean of 0.81; following the eight-week implementation period, post-intervention data yielded a C-SSRS risk score mean of 0.75. There was a marginally significant difference between the means at pre- and post-intervention, showing a lower suicidal risk at post-intervention, p = 0 .07, t-test result (31) = 1.87.
Conclusion: The decrease in patient self-harm behaviors with the implementation of the C-SSRS tool and application of SBBP was not statistically significant (SBBP). However, the decrease did indicate a clinically meaningful improvement in suicidal behavior outcomes after implementation of the intervention.
Akindele, O. (2021). Reducing Patient Risk for Suicidal Behaviors with a Safety Bundle of Best Practices with Non-Psychiatric Patients. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.OFSB1999
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