| Description |
Suicide is preventable, yet is a leading cause of death in the United States. Approximately 1.5 million people receive inpatient psychiatric care each year, and two-thirds of readmissions relate to risk of suicide. Current literature identifies safety-planning interventions (SPIs) as an effective intervention for reducing suicide risk, reducing psychiatric readmissions, and improving patient outcomes. An inpatient psychiatric unit at a regional hospital along the Wasatch Front recently implemented the use of SPIs for each patient in order to improve care and reduce readmissions, but has encountered difficulties with the implementation and has not achieved the anticipated effect. Unit leaders had used an available SPI out of convenience for the implementation. Clinicians expressed frustration with the poor wording and layout of the SPI, which resulted in poor utilization. Patients expressed difficulty understanding the instructions due to phraseology and use of jargon. Overall, the implemented SPI was difficult to utilize and was inefficient. The implemented SPI needed improvement by adapting it for the target population while maintaining or updating evidence-based content in order to achieve improved results. There were three objectives for this project. The first objective was to modify the SPI in use on an inpatient psychiatric unit in order to maximize its use and effectiveness by updating evidence-based content and adapting the layout and wording in order to meet the needs of the target population. The second objective was to present the revised SPI to key decision-makers with recommendations for implementation. The third objective was to disseminate the results of the project via scholarly presentation. A review of current literature helped to identify several potential improvements to the implemented SPI. Current literature indicates that the national average for reading ability is at the seventh grade level. Barriers such as jargon and complicated layouts decrease the likelihood patients will use the SPI. Creators of healthcare tools should consider the target population and avoid barriers, such as reading level and use of jargon, in order to improve utilization. Basic components of an SPI should include warning signs, restriction to harms, utilization of social settings and distractions, involvement of family and friends, and crisis contact information. Implementation was accomplished through appropriate IRB approval, literature review, and assessment of patient, clinician, and organizational needs. A content expert provided consultation for revisions to the SPI template. Presentation of the revised SPI to organizational decision-makers included recommendations for implementation. A poster presentation to the Utah Psychiatric APRN Council fulfilled the goal of dissemination of the results. Completion of this project was successful. Results included: (a) creation of an up-to-date SPI that had been adapted to meet the needs of the target population, (b) presentation of the revised SPI to key decision-makers within the hospital system, and (c) adoption of the revised SPI as a pilot program for the target unit with potential organization-wide distribution. Although SPIs can effectively reduce suicide risk, reduce psychiatric admissions and improve patient outcomes, it is imperative to consider the target population before implementing any intervention or tool. Assessing common barriers to use (e.g., reading comprehension levels and confusing layouts) and modifying tools to meet the needs of the target population can increase utilization and, ultimately, effectiveness of health care tools. |
