A&E nurse training may prove key in detecting high-risk suicide patients

Many patients at risk of suicide end up in the emergency department of their local hospital, but many leave without being seen or referred to a psychiatric professional or are misdiagnosed, according to researchers from the Sharp Grossmont Hospital in San Diego, California.

This is because many nurses working in emergency care are not sufficiently aware of the signs and symptoms of suicide risk, and tend to concentrate on physiologic factors, they said online in the Journal of Emergency Nursing.

In order to try and address this they introduced a programme at the hospital, which comprised a simple tool for assessing suicide risk – scored as either low, medium or high – and a short training course to educate triage nurses about suicide risk and how to respond.

The tool was designed to flag up key risk factors such as easy access to drugs, despondency related to unemployment, family problems or long-term illness.

A guideline was also developed to accompany the tool, setting out the most appropriate level of intervention, such extra observation or referral to a mental health professional.

Overall 118 triage nurses were surveyed on their ability to identify suicide risk prior to the programme and then again after completing it.

Survey scores demonstrated a significant improvement following the training in nurses’ knowledge of how to identify patients at risk for suicide and the best way to treat them, the authors said.

Brian Dolan, a former emergency care nurse and an independent nursing consultant, said he thought UK staff were better than their US counterparts at picking up psychiatric emergencies but further training could always enhance their skills. ‘It is very important and the skills that you develop, you can transfer to any patient group,’ he said Mike Hayward, acute and emergency care adviser for the RCN, agreed.

‘This piece of work is excellent and it is very applicable. The Emergency Care Association in the RCN will be looking at how was can disseminate it more widely.’

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