Wireless Vital Sign Monitoring for Prevention of Suicide in an Inpatient Psychiatric Setting

Suicide is a serious problem in the United States. According to Hoyert and Xu (2012), suicide ranks as the 10th leading cause of death for all ages in the United States and ranks second for young adults age 15-24. Despite efforts made to prevent self-harm in an inpatient hospital setting, suicide continues to be one of the primary sentinel events, resulting in 16% of all hospital deaths in the United States from 2004 - 2012 (Commission, 2012). A sentinel event is an unexpected occurrence that results in death or serious injury; and while the occurrence of a sentinel event does not mean a medical error occurred, the hospital's response to sentinel events is considered a significant indicator of care quality (Commission, 2013). Underscoring the significance of this problem is the inclusion of identifying patients at risk for suicide as one of the Joint Commission's 2013 National Patient Safety Goal (Commission, 2013). A 2006 study showed that acute patient suicidality is the primary reason for inpatient psychiatry hospitalization (Ziegenbein, Anreis, Bruggen, Ohlmeier, & Kropp, 2006). Several interventions are aimed at reducing this risk such as frequent assessment, group and individual psychotherapy, medication management, environmental considerations, and regular visual monitoring. According toJayaram, Sporney, and Perticone (2010), a common practice among inpatient psychiatric units is that of performing a visual check on patients every 15 minutes. Jayaram et al. (2010)concluded that implementation of such a practice was, however, highly inconsistent among the several hospitals and treatment centers reviewed, and furthermore, that visual checks were unreliable in preventing suicide or self-harm. Instead the authors suggested that patients deemed at risk for suicide should receive "close observation (one certified observer to one or more patients), one-to-one observation (one certified observer to one patient), or observation by skilled nursing staff when a patient must be within an arm's reach of the observer" (p. 48).