Clinical Practice Guidelines (CPGs) are useful documents that can support can improve the quality of nursing care available to patients. CPGs guide caregivers to provide emergency and evidence-based nursing support. One of the clinical problems affecting many healthcare settings is suicide risk. Suicide remains “a major health challenge especially in emergency care settings” (Emergency Nurses Association, 2012, p. 2). The selected CPG document for this exercise offers guidelines for effective suicide risk assessment. The title of the document is “Clinical Practice Guideline: Suicide Risk Assessment”.
Scope and Purpose
Suicide remains a leading cause of premature deaths or injuries in the United States. In emergency care settings, suicide remains a major challenge towards delivering evidence-based medical support. This fact explains why the Joint Commission National Patient Safety Goal (NPSG) requires “medical institutions to identify and assess the environmental aspects that can increase the risk for suicide” (Fowler, 2012, p. 82). Individuals who have increased chances of committing suicide will pose a major threat to the healthcare delivery process.
This problem explains why the above Clinical Practice Guideline (GPG) was developed. The document evaluates “the existing literature for the evaluation and assessment of clients who have suicidal ideation” (Emergency Nurses Association, 2012, p. 3). The document can be used to assess patients at increased risk for suicide. The CPG evaluates the scales and tools used to screen patients in emergency care settings. Clients at risk of suicide should receive the most desirable psychiatric intervention.
The health questions covered by the CPG include:
- What are the best predictors and risk assessment tools in screening for suicidal ideation (or self harm) in emergency patients?
- What are the best predictors for self harm across the patient’s life-span?
Stakeholder Involvement
The CPG document was pioneered and authored by the Emergency Nurses Association (ENA). During the document preparation process, ENA formed the Emergency Nursing Resources Committee in order to produce positive results. The committee followed “the guidelines outlined by the ENA Guidelines for Development of Clinical Practice Guidelines” (Emergency Nurses Association, 2012, p. 4). The committee included a number of healthcare professionals such as psychologists, social workers, nurse practitioners (NPs), and physicians. The involvement of these stakeholders made it easier for the committee to come up with a powerful CPG document.
Rigor of Development
In order to present an evidence-based CPG document, the committee reviewed and analyzed different literature materials. The articles used to develop the document were selected from a number of databases. The committee selected the most relevant articles that had been published within the past five years (Emergency Nurses Association, 2012). Several databases were considered in order to get the most appropriate articles. The targeted databases included Google Scholar, PubMed, MEDLINE, CINAHL, and TRIP Data Base.
The questions presented above were used to “conduct a systematic review of evidence” (Emergency Nurses Association, 2012, p. 3). Some key words such as suicide, suicide assessment, suicidal ideation, and suicide tools were used during the research study. Articles that fulfilled the criteria were considering throughout the formulation of the CPG. Additionally, the guidelines presented by different organizations such as the American Nursing Association (ASA) and the World Health Organization (WHO) were considered in order to develop the CPG document.
Clarity and Presentation
The CPG document presents powerful recommendations that can be used to support the needs of patients who at risk of suicide. To begin with, suicide screening should be conducted using adequate tools. This approach will support the health needs of many emergency department clients. The second issue revolves around the use of computer-based tools. Such tools are feasible and appropriate for patients who are 11 years of age and above. The other powerful recommendation outlined in the CPG is the need to train emergency department workers. When “such caregivers are trained, they find it easier to screen patients for suicide risk” (Sanchez-Teruel, García-Leon, & Muela-Martinez, 2014, p. 956).
The other important recommendation is the ability to predict risks for suicide. For instance, previous episodes of self harm or suicide can be used adequately by healthcare workers. The screening process should be part of the assessment and healthcare delivery initiative. The occurrence of negative experiences or life events should be considered throughout the healthcare delivery process. The CPG goes further to describe why specific instruments such as Patient Health Questionnaire (PHQ) and Modified SAD Persons Scale (MPSP) should never be used to assess individuals at risk of suicide (Sanchez-Teruel et al., 2014). When such patients are assessed, it becomes easier for healthcare workers to provide the most desirable healthcare intervention.
Applicability
This CPG targeted different emergency departments. Many patients in these departments tend to have increased chances of committing suicide or injuring themselves (Fowler, 2012). During the healthcare delivery process, medical workers should be aware of the challenges affecting their patients. The document offers useful concepts and approaches to assess patients at risk of self harm. The use of the right tools and assessment procedures will support the changing needs of many patients.
The presented document can be implemented in a wide range of healthcare settings. This is the case because suicide affects many people in different developmental stages. The document can be used by nurses, caregivers, psychiatrists, and psychologists to identify clients who are at risk of suicide. Institutions providing mental health services to different patients will find this document helpful. However, some barriers such as the costs incurred when using computer-aided assessment systems can affect the implementation of the CPG. Medical institutions planning to implement the CPG document will have to incur numerous expenses (Fowler, 2012). Training is also needed to ensure the targeted practitioners can use the CPG successfully.
Editorial Independence
Throughout the CPG development process, the members of the committee offered powerful insights to support the targeted clinical problem. The document shows conclusively that the involved stakeholders did not have any conflict of interest. However, the individuals were unable to settle on the right assessment procedures required for patients at risk of suicide. However, the formulated criteria for article inclusion addressed the differences. Additionally, the chairman of the committee offered powerful guidelines to support the CPG development process (Sanchez-Teruel et al., 2014). The chairman handled the challenges affecting the committee in a professional manner.
Summary
The CPG answers the outlined key clinical questions in adequately. The document describes the best risk assessment tools and predictors that can be used to screen for self harm or suicidal ideation. Nursing students will find this CPG appropriate throughout their future healthcare practices. The document outlines powerful procedures for assessing patients at risk of suicide. Although the CPG document targets patients in emergency departments, it is also applicable in a wide range of medical settings (Fowler, 2012). This CPG will guide nurses to assess patients at risk of suicide and provide evidence-based healthcare support.
References
Emergency Nurses Association. (2012). Clinical practice guideline: Suicide risk assessment. Web.
Fowler, J. (2012). Suicide risk assessment in clinical practice: Pragmatic guidelines for imperfect assessments. Psychotherapy, 49(1), 81-90.
Sanchez-Teruel, D., García-Leon, A., & Muela-Martinez, J. (2014). Prevention, assessment and treatment of suicidal behavior. Anales de Psicologia, 30(3), 952-963.