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1.
Jt Comm J Qual Patient Saf ; 46(7): 417-426, 2020 07.
Article in English | MEDLINE | ID: mdl-32473966

ABSTRACT

INTRODUCTION: Hospitals have become an important venue for identifying medical patients with occult suicidality. This article describes the implementation of a quality improvement project at the National Institutes of Health Clinical Center (NIHCC) to systematically screen medical/surgical inpatients for suicide risk. METHODS: Using the Plan-Do-Study-Act method, questions from the Ask Suicide-Screening Questions (ASQ) tool were deployed with medical inpatients aged 10 years and older between April 2018 and April 2019. Goals included the development of a training program, policy and procedure review, electronic medical record integration and data collection, and ongoing management and troubleshooting. RESULTS: A total of 4,284 patients were screened for suicide risk with a nurse screening compliance rate of 94.3%. Prevalence data on patients aged 10 years and older revealed an overall screen positive rate of 2.3% (97/4,284), with 3.1% of youth aged 10 to 24 years and 2.2% of adults screening positive. Of the 97 patients who screened positive, 96 were non-acute positive screens. Of the full sample, only 1 patient (0.02%) was deemed acute positive, requiring a 1:1 observer and full safety precautions. CONCLUSION: Universal suicide risk screening was successfully implemented in the NIHCC without incurring a need for additional resources. The intermediate step of a brief suicide safety assessment is a critical part of the workflow, providing guidance for determining appropriate follow-up in a safe and efficient manner that spares limited mental health and hospital resources. Given the increasing suicide rates in the general population, medical venues offer important opportunities for early detection, assessment, and referral.


Subject(s)
Suicide Prevention , Adolescent , Adult , Humans , Inpatients , Mass Screening , Quality Improvement , Referral and Consultation
2.
Oncol Nurs Forum ; 38(2): E72-80, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21356644

ABSTRACT

PURPOSE/OBJECTIVES: To develop and validate a taxonomy for the domain of clinical research nursing. DESIGN: Survey. SETTING: Clinical research settings in the United States. SAMPLE: A purposefully selected expert panel of 22 nurses who were actively practicing or supervising in a clinical research environment. METHODS: A study team consisting of nurses with experience in clinical research synthesized peer-reviewed articles, academic curricula, professional guidelines, position descriptions, and expert opinion. Using the Delphi technique, three rounds of surveys were conducted to validate the taxonomy. The three sequential questionnaires were completed over five months. MAIN RESEARCH VARIABLES: Activities performed by nurses in a clinical research setting. FINDINGS: A taxonomy for clinical research nursing was validated with five dimensions and 52 activities: Clinical Practice (4 activities), Study Management (23 activities), Care Coordination and Continuity (10 activities), Human Subjects Protection (6 activities), and Contributing to the Science (9 activities). CONCLUSIONS: This study validated activities for direct care providers and nurses with the primary focus of research coordination. The findings identify a variety of activities that are unique to nurses in a clinical research setting. IMPLICATIONS FOR NURSING: Nurses play an integral role in the clinical research enterprise. Validating a taxonomy for the specialty of clinical research nursing allows for roles to be compared across settings, competency requirements to be defined, and nursing organizations to be guided in the development of specialty certification.


Subject(s)
Classification , Clinical Nursing Research/methods , Clinical Nursing Research/standards , Adult , Data Collection/methods , Data Collection/standards , Delphi Technique , Female , Humans , Middle Aged , Surveys and Questionnaires , United States
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