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    Screening for Suicidal Ideation and Attempts Among Emergency Department Medical Patients: Instrument and Results from the Psychiatric Emergency Research Collaboration

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    Authors
    Allen, Michael H.
    Abar, Beau W.
    McCormick, Mark
    Barnes, Donna H.
    Haukoos, Jason
    Garmel, Gus M.
    Boudreaux, Edwin D.
    UMass Chan Affiliations
    Department of Emergency Medicine
    Document Type
    Journal Article
    Publication Date
    2013-06-01
    Keywords
    Suicide
    Suicidal Ideation
    Suicide, Attempted
    Emergency Service, Hospital
    Emergency Medical Services
    Mass Screening
    Emergency Medicine
    Health Services Research
    Mental and Social Health
    Psychiatry
    Psychiatry and Psychology
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    Link to Full Text
    http://dx.doi.org/10.1111/sltb.12018
    Abstract
    Joint Commission National Patient Safety Goal 15 calls for organizations "to identify patients at risk for suicide." Overt suicidal behavior accounts for 0.6% of emergency department (ED) visits, but incidental suicidal ideation is found in 3%-11.6%. This is the first multicenter study of suicide screening in EDs. Of 2,243 patients in six diverse emergency settings, 1,068 (47.7%) were screened with a brief instrument. Depression was endorsed by 369 (34.5%); passive suicidal ideation by 79 (7.3%); and active suicidal ideation by 24 (2.3%). One hundred thirty-seven (12.8%) reported prior attempts, including 35 (3.3%) with current suicidal ideation. Almost half of those with current ideation had a prior attempt (43.8%) versus those without current ideation, 10.3%, chi(2) (1) = 75.59, p < .001. Twenty cases (25%) were admitted to medical services, but only 10 (12.5%) received mental health assessment; none were admitted directly to a psychiatry service. The prevalence of suicidal ideation here is similar to previous studies but the frequency of prior attempts has not been reported. The 35 cases with current ideation and prior attempt are at risk. As they did not present psychiatrically, they would likely have gone undetected. Despite reporting these cases to clinical staff, few received risk assessment.
    Source
    Suicide Life Threat Behav. 2013 Jun;43(3):313-23. doi: 10.1111/sltb.12018 Link to article on publisher's site
    DOI
    10.1111/sltb.12018
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/28530
    PubMed ID
    23413776
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1111/sltb.12018
    Scopus Count
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    UMass Chan Faculty and Researcher Publications
    Emergency Medicine Publications

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      Outpatient Emergency Department Utilization: Measurement and Prediction: A Dissertation

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      Emergency Department Nurses' Experiences of Violent Acts in the Workplace

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      Emergency department nurses are at high risk for violence in the workplace (Keely, 2002; Fernandez et al., 1998; Nachreiner et al., 2005; Mayer et al., 1999). It is estimated that between 52% and 82% of emergency nurses will experience physical violence and 100% of emergency department nurses will experience non-physical violence in their careers. Despite this fact, there are limited studies examining workplace violence among this vulnerable group (Fernandez et al., 1998; Levin et al., 1998). Therefore, the purpose of this qualitative descriptive study was to examine the experiences of emergency department nurses with workplace violence. Levin et al.’s (2003) Ecological Occupational Model (EOHM) was used to guide this study. Four focus groups were conducted with 27 nurses who represented different types of emergency departments (rural community facility to large urban Level 1 trauma center). Results of the study suggested that the majority of participants (96%) experienced some form of work-related violence and 75% had attended at least one violence education class. The major themes of frustration and powerlessness emerged from the data. Sub themes included professional conflict while caring for violent patients, personal detachment as an emotional survival mechanisms, and feelings of victimization. Additional factors contributing to workplace violence included: personal attributes of the nurse, the workplace, and the community where the emergency department was located. These study results have potential to guide intervention development aimed at reducing workplace violence in the emergency department setting.
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