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Frost DA, Snydeman CK, Lantieri MJ, et al. Psychosomatics. 2019;61:154-160.
This study assessed the effectiveness of a suicide prevention checklist in a single hospital developed based on Joint Commission recommendations. In the two years following checklist implementation, suicide attempts decreased by 42% (compared to the preceding two years); the number of patients sustaining temporary or minor injuries also decreased by 57% across the same time period. Survey responses showed that unit nurses felt the checklist list created a safe environment (88%) and that it supported consistent practice (90%) of caring for potentially suicidal patients in nonpsychiatric units.
Glauser G, Goodrich S, McClintock SD, et al. J Thorac Cardiovasc Surg. 2021;162:155-164.e2.
Surgical overlap is a longstanding practice, and reports suggest a link to postoperative complications and patient safety. This study measured the impact of overlap on patient outcomes among patients undergoing cardiac surgical interventions over a two-year period and found that overlap did not predict mortality, readmission, reoperation or emergency department visits at 30- or 90-days post-discharge, compared to patients without surgical overlap.
A woman with a history of depression, anxiety, and posttraumatic stress disorder presented to the emergency department after a suicide attempt. Physical examination was significant for depressed affect and superficial lacerations to the bilateral forearms. Her left forearm laceration was sutured and bandaged with gauze. A psychiatrist evaluated her and placed an involuntary legal hold. Upon arrival to the inpatient psychiatric unit, the patient asked to use the bathroom. She unwrapped her wrist bandage, wrapped it around her neck and over the shower bar, and tried to hang herself.
Mills PD, Watts V, Miller S, et al. Jt Comm J Qual Patient Saf. 2010;36:87-93.
Suicide in a hospitalized patient is considered a never event. The majority of inpatient suicide attempts occur in patients hospitalized on psychiatric units, and a prior study conducted in Veterans Affairs hospitals used root cause analysis to identify predisposing factors for suicide attempts. Based on those findings, in this study, the authors report on the development of a checklist to identify and minimize suicide hazards in mental health facilities. The checklist primarily focused on eliminating environmental hazards, such as anchor points for hanging attempts and materials that could be used as weapons. After implementation of the checklist, over three-quarters of potential hazards were removed. A case of a suicide attempt on a medical unit is discussed in an AHRQ WebM&M commentary.