Citation

Horowitz LM, Snyder D, Ludi E, Rosenstein DL, Kohn-Godbout J, Lee L, Cartledge T, Farrar A, Pao M. Psychosomatics 2013; 54(3): 239-247.

Affiliation

Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, MD. Electronic address: horowitzl@mail.nih.gov.

Copyright

(Copyright © 2013, Academy of Psychosomatic Medicine, Publisher Elsevier Publishing)

DOI

10.1016/j.psym.2013.01.002

PMID

23398908

Abstract

BACKGROUND: Suicide in hospital settings is a frequently reported sentinel event to the Joint Commission (JC). Since 1995, over 1,000 inpatient deaths by suicide have been reported to the JC; 25% occurred in non-behavioral health settings. Lack of proper "assessment" was the leading root cause for 80% of hospital suicides. This paper describes the "Ask Suicide-Screening Questions to Everyone in Medical Settings (asQ'em)" Quality Improvement Project. We aimed to pilot a suicide screening tool and determine feasibility of screening in terms of prevalence, impact on unit workflow, impact on mental health resources, and patient/nurse acceptance. METHODS: We piloted the asQ'em two-item screening instrument that assesses suicidal thoughts and behaviors, designed specifically for nurses to administer to medical patients. Educational in-services were conducted. A convenience sample of adult patients, 18 years or older, from three selected inpatient units in the National Institutes of Health Clinical Center, participated. RESULTS: A total of 331 patients were screened; 13 (4%) patients screened "positive" for suicide risk and received further evaluation. No patient had acute suicidal thoughts or required an observational monitor. Screening took approximately 2 minutes; 87% of patients reported feeling comfortable with screening; 81% of patients, 75% of nurses, and 100% of social workers agreed that all patients in hospitals should be screened for suicide risk. DISCUSSION: Nurses can feasibly screen hospitalized medical/surgical patients for suicide risk with a two-item screening instrument. Patients, nurses, and social workers rated their experience of screening as positive and supported the idea of universal suicide screening in the hospital.

Language: en