Research Question
In patients who utilize psychiatric services, does the implementation of observation or no suicide contracts increase patient safety? The use of various observation methods, including no-suicide contracts (NSC), in the treatment of patients who utilize psychiatric services is currently the standard of care. The use of no-suicide contracts became commonplace in the USA in 1973 when Drye, Goulding, & Goulding published a report which reflected data from their own practice.
McMyler and Pryjmachuk (2008) explain Drye’s study:
Firstly, within a 5-year period in the authors’ own practice, NSCs had been made with 600 service users and none had resulted in suicide. Secondly, as part of the study, Drye et al. surveyed 31 therapists who were using NSCs and ascertained that, in the 609 cases wherein the NSC had been used in accordance with their instructions, there had been no suicides. (p. 513)
A no-suicide contract is an agreement between a provider and a patient who utilizes psychiatric services. This agreement is “sometimes verbal but usually written, whereby the service user pledges not to harm themselves… they commonly comprise a statement of assent, details of the duration of the agreement and a contingency plan in the event that the service user feels unable to uphold the agreement” (McMyler & Pryjmachuk, 2008, p. 513).
Included in the treatment of psychiatric patients, differing levels of observation have also been used. These levels of observation include: “routine or general observation, 30- to 15-min checks, and constant or continuous observation” (Manna, 2009, p. 268). While a mental health professional such as a Licensed Professional Counselor, Licensed Clinical Social Worker, Psychiatrist, or Advance...
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Murphy, E., Kapur, N., Webb, R., & Cooper, J. (2011). Risk assessment following self-harm: comparison of mental health nurses and psychiatrists. Journal Of Advanced Nursing, 67(1), 127-139. doi:10.1111/j.1365-2648.2010.05484.x
National Institute of Mental Health. (2014).
Puskar, K., & Urda, B. (2011). Examining the Efficacy of No-Suicide Contracts in Inpatient Psychiatric Settings: Implications for Psychiatric Nursing. Issues In Mental Health Nursing, 32(12), 785-788. doi:10.3109/01612840.2011.599476
QSEN Quality and Safety Education for Nurses. (n.d.). QSEN Quality and Safety Education for Nurses. Retrieved February 1, 2014 from http://www.qsen.org.
Range, L., Campbell, C., Kovac, S., Marion-Jones, M., Aldridge, H., Kogos, S., & Crump, Y. (2002). No-suicide contracts: an overview and recommendations. Death Studies, 26(1), 51-74.
Sloss, David. "The Right to Choose How to Die: A Constitutional Analysis of State Laws Prohibiting Physician-Assisted Suicide." Stanford Law Review. 48.4 (1996): 937-973. Web. 2 March 2015.
The QSEN initiative is the progression of quality and safety of education for nurses that began in 2005 and has been continued over the past eight years. It is a multi-phase process that shows current and future nurses how to apply knowledge, skills, and attitudes to their everyday nursing activities(QSEN, 2013, 1). Nurses and student nurses can use their knowledge, skills and attitudes to help prevent never events such as hospital acquired conditions. Never events are medical errors that could have been serious and preventable. They could have been caused by poor communication, lack of proper nursing skills, or simply just negligence. QSEN can also be used to improve nursing outcomes for everyone involved in the healthcare field.
Nurses are key components in health care. Their role in today’s healthcare system goes beyond bedside care, making them the last line of defense to prevent negative patient outcomes (Sherwood & Zomorodi, 2014). As part of the interdisciplinary team, nurses have the responsibility to provide the safest care while maintaining quality. In order to meet this two healthcare system demands, the Quality and Safety Education for Nurses (QSEN) project defined six competencies to be used as a framework for future and current nurses (Sherwood & Zomorodi, 2014). These competencies cover all areas of nursing practice: patient-centered care, teamwork and collaboration, evidence-based practice, quality
distant cousin of euthanasia, in which a person wishes to commit suicide. feels unable to perform the act alone because of a physical disability or lack of knowledge about the most effective means. An individual who assists a suicide victim in accomplishing that goal may or may not be held responsible for. the death, depending on local laws. There is a distinct difference between euthanasia and assisted suicide. This paper targets euthanasia; pros and cons. not to be assisted in suicide. & nbsp; Thesis Argument That Euthanasia Should Be Accepted & nbsp;
"Assisted Suicide: Finding Common Ground." Lois Snyder, JD; and Authur L. Caplan, PhD. Annals of Internal Medicine. March 21, 2000. v.132, n.6
It is expected that public school nurses will be successful in their interventions, and students will sign up for counseling sessions and group meetings. In addition, the desired outcome is that patients in clinics and other health care settings will be willing to fill out questioners and acquire about the suicide prevention therapies. It is expected that these interventions lower the rate of attempted and completed suicide in Spokane and Spokane county.
Lesser, H. (2010). Should it be legal to assist suicide?. Journal Of Evaluation In Clinical
The Quality and Safety Education for Nurses (QSEN’s) goal is to prepare future nurses with the knowledge, skills, and attitudes (KSAs) that are needed to continuously improve the quality and safety of the healthcare systems within which they work. QSEN focuses on six main competencies; patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As we have learned in earlier classes these competencies and their KSAs offer a base to help us and other nurses as we continue our education and become RNs. As we will learn in this class these KSAs go hand in hand with health assessment.
The thought of life coming to an end is a scary thought for anyone, but for someone who is depressed and suicidal it may seem to them as a release of some kind. In reality is suicide going to solve these patient’s problems? The patient may think so, but it will not solve any issues or problems. Suicide is a pertinent solution that no one can return from. My experience with depressed and suicidal people or patients is small. This is why I chose to write about patients who are depressed and suicidal. Even though my experience is small. I want to learn what can be done for these patients, and how I can be a better advocate for them.
[2] R. M. Walker, "Physician- assisted suicide: the legal slippery slope," Cancer Control : Journal of the Moffitt Cancer Center, vol. 8, pp. 25, 2001.
Styer, Denise M. "An Understanding of Self-Injury and Suicide." Prevention Researcher Integrated Research Services, Inc., Vol. 13, Supplement. Dec. 2006: 10-12. SIRS Issues Researcher. Web. 16 Apr. 2014. .
Because of the high risk of morbidity it is important for healthcare providers to be proficient in suicide screenings as it can assist in preventing suicides.
The overall goal for the Quality and Safety Education for Nurses (QSEN) plan is to meet the challenge of educating and preparing future nurses to have the knowledge, skills and attitudes that are essential to frequently progress the quality and safety of the healthcare systems in the continuous improvement of safe practice (QSEN, 2014).Safety reduces the possibility of injury to patients and nurses. It is achieved through system efficiency and individual work performance. Organizations determine which technologies have an effective protocol with efficient practices to support quality and safety care. Guidelines are followed to reduce potential risks of harm to nurses or others. Appropriate policies
Urofsky, Melvin I. Lethal Judgments: Assisted Suicide and American Law. Lawrence: University Press of Kansas, 2000. Print.
New Haven: Yale University Press, 2004. Print. The. Suicide and Suicidal Behaviors. Suicide : Medline Plus.