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dc.contributor.authorCaterino, Jeffrey M.
dc.contributor.authorSullivan, Ashley F.
dc.contributor.authorBetz, Marian E.
dc.contributor.authorEspinola, Janice A.
dc.contributor.authorMiller, Ivan
dc.contributor.authorCamargo, Carlos A. Jr.
dc.contributor.authorBoudreaux, Edwin D
dc.contributor.authorEmergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) Investigators
dc.date2022-08-11T08:08:17.000
dc.date.accessioned2022-08-23T15:49:52Z
dc.date.available2022-08-23T15:49:52Z
dc.date.issued2013-08-15
dc.date.submitted2014-01-27
dc.identifier.citationCaterino JM, Sullivan AF, Betz ME, Espinola JA, Miller I, Camargo CA Jr, Boudreaux ED; Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) Investigators. Evaluating current patterns of assessment for self-harm in emergency departments: a multicenter study. Acad Emerg Med. 2013 Aug;20(8):807-15. doi: 10.1111/acem.12188. <a href="http://dx.doi.org/10.1111/acem.12188" target="_blank">Link to article on publisher's site</a>
dc.identifier.issn1069-6563 (Linking)
dc.identifier.doi10.1111/acem.12188
dc.identifier.pmid24033624
dc.identifier.urihttp://hdl.handle.net/20.500.14038/28536
dc.description.abstractOBJECTIVES: The objective was to describe self-harm assessment practices in U.S. emergency departments (EDs) and to identify predictors of being assessed. METHODS: This was a prospective observational cohort study of adults presenting to eight U.S. EDs. A convenience sample of adults presenting to the EDs during covered research shifts was entered into a study log. Self-harm assessment was defined as ED documentation of suicide attempt; suicidal ideation; or nonsuicidal self-injury thoughts, behaviors, or both. Institution characteristics were compared relative to percentage assessed. To identify predictive patient characteristics, multivariable generalized linear models were created controlling for weekend presentation, time of presentation, age, sex, and race and ethnicity. RESULTS: Among 94,354 charts, self-harm assessment ranged from 3.5% to 31%, except for one outlying site at 95%. Overall, 26% were assessed (11% excluding the outlying site). Current self-harm was present in 2.7% of charts. Sites with specific self-harm assessment policies had higher assessment rates. In the complete model, adjusted risk ratios (aRR) for assessment included age >/= 65 years (0.56, 95% confidence interval [CI] = 0.35 to 0.92) and male sex (1.17, 95% CI = 1.10 to 1.26). There was an interaction between these variables in the smaller model (excluding outlying site), with males < 65 years of age being more likely to be assessed (aRR = 1.14, 95% CI = 1.02 to 1.37). CONCLUSIONS: Emergency department assessment of self-harm was highly variable among institutions. Presence of specific assessment policies was associated with higher assessment rates. Assessment varied based upon patient characteristics. The identification of self-harm in 2.7% of ED patients indicates that a substantial proportion of current risk of self-harm may go unidentified, particularly in certain patient groups.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=24033624&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1111/acem.12188
dc.subjectEmergency Medicine
dc.subjectPsychiatric and Mental Health
dc.subjectPsychiatry and Psychology
dc.titleEvaluating current patterns of assessment for self-harm in emergency departments: a multicenter study
dc.typeJournal Article
dc.source.journaltitleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine
dc.source.volume20
dc.source.issue8
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/emed_pp/79
dc.identifier.contextkey5026608
html.description.abstract<p>OBJECTIVES: The objective was to describe self-harm assessment practices in U.S. emergency departments (EDs) and to identify predictors of being assessed.</p> <p>METHODS: This was a prospective observational cohort study of adults presenting to eight U.S. EDs. A convenience sample of adults presenting to the EDs during covered research shifts was entered into a study log. Self-harm assessment was defined as ED documentation of suicide attempt; suicidal ideation; or nonsuicidal self-injury thoughts, behaviors, or both. Institution characteristics were compared relative to percentage assessed. To identify predictive patient characteristics, multivariable generalized linear models were created controlling for weekend presentation, time of presentation, age, sex, and race and ethnicity.</p> <p>RESULTS: Among 94,354 charts, self-harm assessment ranged from 3.5% to 31%, except for one outlying site at 95%. Overall, 26% were assessed (11% excluding the outlying site). Current self-harm was present in 2.7% of charts. Sites with specific self-harm assessment policies had higher assessment rates. In the complete model, adjusted risk ratios (aRR) for assessment included age >/= 65 years (0.56, 95% confidence interval [CI] = 0.35 to 0.92) and male sex (1.17, 95% CI = 1.10 to 1.26). There was an interaction between these variables in the smaller model (excluding outlying site), with males < 65 years of age being more likely to be assessed (aRR = 1.14, 95% CI = 1.02 to 1.37).</p> <p>CONCLUSIONS: Emergency department assessment of self-harm was highly variable among institutions. Presence of specific assessment policies was associated with higher assessment rates. Assessment varied based upon patient characteristics. The identification of self-harm in 2.7% of ED patients indicates that a substantial proportion of current risk of self-harm may go unidentified, particularly in certain patient groups.</p>
dc.identifier.submissionpathemed_pp/79
dc.contributor.departmentDepartment of Emergency Medicine
dc.source.pages807-15


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