Suicide Precaution Policy

Suicide Precaution Policy

This paper presents recommendations for suicide prevention policy with a focus on approaches to create a safe environment for handling clients during admission and discharge, expectations for client monitoring, and other nursing expectations, including how to interact with suicidal clients, documentation, and the roles of various types of nurses within the newly opened observation unit at the psychiatric facility.

Creating a Safe Environment

Considerations or Actions Needed When a Client is Admitted or Discharged

The nurse must conduct a full body search and a search of their personal items, as well as assess for any dangers and potentially harmful items in the assessment area. Patients who have been presented to the hospital with suicidal ideation have an increased risk of repeat presentation and self-harm in the future (Griffin et al., 2020). The nurse should also consider assessing the client for any medical conditions and inspecting them for medications. If any medical conditions or use of medications are suspected or identified, the nurse should record them and inform the supervisor immediately. In fact, medications for managing suicide risk factors, such as antidepressants for Major Depressive Disorder (MDD), have been linked to a further increase in the risk for suicidal ideation and behaviors (Fornaro et al., 2019).

After the assessment has been concluded, the decision for admission made, and the client has been admitted, the nurse should inspect the client’s room for any potentially dangerous items before admission. It is also important to ensure the client’s room is close to the nurse station and easily accessible in case of an emergency.

During discharge, the nurse must assess the client’s medical and mental stability. The nurse must also provide education and other learning materials on suicide care and observation to the caregiver. The nurse should also ensure that the client is accompanied by a caregiver or an individual who can observe the client after discharge. A qualified nurse must also accompany the patient and their caregiver to inspect the living conditions.

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Considerations or Actions during the Client’s Admission (Length of Stay)

During the client’s length of stay, the nurse must first place a warning signage in the client’s room. The nurse must continuously assess the physical environment for dangerous items. Additionally, for more patient and staff safety, only plastic utensils and other dinnerware should be used during the entire stay. The nurse must conduct a body search and belongings search for every client visitor before they proceed to meet the client, whether outside or within the client’s room. Additionally, such visits should be supervised by qualified personnel, including a member of the nursing staff and security staff.

Allowable and Restricted Personal Items for the Client

The following personal items are restricted for the client: any types of drugs and related items, any glass-made personal items, any items for personal care and grooming that are sharp and can cause harm, including jewelry, any personal, shaving razors, high-heeled shoes, and bras with support wires and long straps. Other personal items such as personal clothes, toothbrushes, medications, and personal beddings, among other items that may be considered potentially dangerous, are not allowable. The client will be provided with needed personal items by the facility. Only physician-ordered medical deviations (CPAP) are allowed in the client’s room.

Expectations of Client Monitoring

A system combining video monitoring, radio frequency identification (RFID), and machine learning technologies is recommended for client monitoring. Systems utilizing RFID technologies, such as Remote Patient Monitoring (RPM), have been successfully applied and utilized to detect early suicidal behaviors and risk of self-harm in mental health facilities (Tao et al., 2021). Additionally, the clients must be supervised at all times, including when using bathrooms and during other activities of daily living. Licensed practical nurses (LPNs) will be assigned the role of monitoring the client physically and using the installed monitoring technology remotely.

Nursing Considerations

Expectations of Nursing Interactions When Dealing With Suicidal Clients

All nurses assigned roles in the psychiatry unit must ensure their competency to care for and manage suicidal patients. Nurses are expected to be comfortable around suicidal clients. This means ensuring they create a safe and effective therapeutic environment.

Required Documentation Expectations

Having the right documentation protects against the escalation of malpractice cases and claims (Shenoy et al., 2022), for instance, in case of client suicide. The nurse is expected to provide full assessment documentation, which provides any actions taken during the first encounter with a patient, briefings on the assessed risk of suicide, and any reasons that indicate and support reasons for nursing actions and assessments made as recommendations for further actions. A root cause analysis (RCA) can be provided to support the assessed risk of suicide.

A Description of the Roles of CNA, LPN, and RN

The following are the roles of the nurses assigned to the psychiatry unit within the facility:

• Psychiatric CNAs will be expected to utilize their competencies in psychiatry, and mental health to diagnose cases as well as administer medications.
• RNs in the unit will be expected to carry out all behavioral health assessments after every shift as well as document all progress achieved through nursing.
• LPNs will support the CNA, the RN, and other professionals in delivering nursing care to the clients in the unit.
  

References

Fornaro, M., Anastasia, A., Valchera, A., Carano, A., Orsolini, L., Vellante, F., Rapini, G., Olivieri, L., Natale, S. di, Perna, G., Martinotti, G., di Giannantonio, M., & de Berardis, D. (2019). The FDA “black box” warning on antidepressant suicide risk in young adults: More harm than benefits? Frontiers in Psychiatry, 10(MAY), 294. https://doi.org/10.3389/FPSYT.2019.00294/BIBTEX

Griffin, E., Kavalidou, K., Bonner, B., O’Hagan, D., & Corcoran, P. (2020). Risk of repetition and subsequent self-harm following presentation to hospital with suicidal ideation: A longitudinal registry study. EClinicalMedicine, 23, 100378. https://doi.org/10.1016/J.ECLINM.2020.100378

Shenoy, A., Shenoy, G. N., & Shenoy, G. G. (2022). Expert witness testimony in medical malpractice litigation: Minutiae and methods – In credence and credibility. Ethics, Medicine and Public Health, 21, 100755. https://doi.org/10.1016/J.JEMEP.2022.100755

Tao, X., Shaik, T. B., Higgins, N., Gururajan, R., & Zhou, X. (2021). Remote Patient Monitoring Using Radio Frequency Identification (RFID) Technology and Machine Learning for Early Detection of Suicidal Behaviour in Mental Health Facilities. Sensors 2021, Vol. 21, Page 776, 21(3), 776. https://doi.org/10.3390/S21030776

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Suicide Precaution Policy

To demonstrate an understanding of creating a therapeutic and safe environment for a suicidal client.

Instructions:

This assignment will use a Word document to create a policy outline. Clearly identify sections of the policy based on the listed expectations.

Content:

You are working on a newly opened observation unit in the hospital. Recently, there has been an overflow of suicidal clients awaiting placement at the psychiatric facility. The staff recognizes there is not a fully developed policy on how to care for a suicidal client safely. Working together with case management and other staff nurses, you have been asked to create policy recommendations. Your recommendations should include:

How to create a safe environment
Considerations or actions needed when a client is admitted or discharged
Considerations or actions during the client’s admission (length of stay)
Identify allowable and restricted personal items for the client
Expectations of client monitoring
Describe the requirements of how the client is to be monitored, how often, and by whom.
Nursing Considerations
Expectations of nursing interactions when dealing with suicidal client
Required documentation expectations
Describe the roles of CNA, LPN, RN