Abstract
BackgroundEmergency Departments are underutilized settings for suicide prevention and management as patients with occult (camouflaged) suicides and suicidal ideation are rarely screened by nurses and other health workers in these sites. The under-detection rates could be a result of lack of suicide assessment and management confidence among the hospital staff. The aim of the study was to find out the perceived self-efficacy in suicide risk assessment, management and referral among nurses working in an emergency department within a lower income country.MethodThe Risk Assessment and Management Self-Efficacy Scale (RAMSES) was administered among nurses in an emergency department (ED) within an urban region in a descriptive study. The risk assessment, management and referral domains among 64 respondents were evaluated using mean and standard deviation calculations in SPSS v 21.ResultsThe total RAMSES composite score in risk assessment, management and referral was 6.19 (SD 2.107) with risk assessment having the lowest mean score of 6.09 (SD 2.08), while risk referral process mean score was the highest at 6.55 (SD 2.36). The nurses had the least confidence in developing a written risk management plan 5.68 (SD 2.51) as well as using screening instruments to assess risk 5.90 (SD 2.15).FindingsNurses in emergency department have below average self-efficacy in suicide assessment and management necessitating training as well as integration of protocols that could enhance effective utilization of emergency departments as suicide prevention and management settings.
Highlights
One in five people who have committed suicide have had contact with a health professional [12]
A study conducted among African Americans showed that out of all the patients presenting at the Emergency Department with suicidal symptoms, only 25% of them were identified as having suicidal ideations with 76% of the respondents being discharged home and only 39% of them having at least one follow up session [9]
The study findings show that Nurses could benefit from trainings on suicide assessment and management, and especially in using suicide screening tools that can be administered within a short time, bearing in mind that this is a busy hospital setting, and that can reflect a true diagnostic picture, owing to validity and reliability of the tool
Summary
One in five people who have committed suicide have had contact with a health professional [12]. Suicidal assessment and management on initial contact with a health professional is an important preventive and curative intervention; yet in many settings, most cases go undetected. In America, around 1089 people who had visited hospitals including emergency departments in between 2010 and 2014 committed suicide and this. Another study has shown that the more frequent the emergency department visits, the higher the risk of suicide [11]. Emergency Departments are underutilized settings for suicide prevention and management as patients with occult (camouflaged) suicides and suicidal ideation are rarely screened by nurses and other health workers in these sites. The aim of the study was to find out the perceived self-efficacy in suicide risk assessment, management and referral among nurses working in an emergency department within a lower income country
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