Citation

Drew BL. Arch. Psychiatr. Nurs. 2001; 15(3): 99-106.

Copyright

(Copyright © 2001, Elsevier Publishing)

DOI

10.1053/apnu.2001.23748

PMID

11413501

Abstract

Although negotiation of no-suicide contracts is common practice, research regarding the outcomes of contracting is inadequate. The purpose of this retrospective review of medical records was to examine how no-suicide contracting affected the likelihood of self-harm behavior in psychiatric inpatient settings. Thirty-one patients (4.8%) engaged in self-harm behaviors representing 2.64% of all patients admitted to both study settings during the 6 (1/2)-month period from which data were collected. Approximately half of those patients expressed suicidal intent. Logistic regression analysis suggested that patients with no-suicide contracts and with higher levels of restriction had a significantly higher likelihood of self-harm behavior (OR = 7.43 and 2.47, respectively, p =.005). Consistency of nursing assignment is likely associated with a lower probability of self-harm (OR =.07) but p.068 when this variable was included in the model. Prevention of self-harm behaviors by the use of no-suicide contracting is not shown. Negotiation of a contract is likely a reflection of staff assessment that the patient was at high risk for suicide. These findings confirm the need for thorough, ongoing assessment of suicidal risk, whether or not a patient has agreed to a no-suicide contract.

Language: en

Keywords

Female; Hospital Units; Humans; Inpatients; Logistic Models; Male; Negotiating; Nurse-Patient Relations; Nursing Assessment; Nursing Evaluation Research; Outcome Assessment, Health Care; Patient Participation; Psychiatric Nursing; Retrospective Studies; Risk Factors; Self-Injurious Behavior; Suicide; Suicide Prevention