Accreditation

Check(list) your ER for suicide risks

Briefings on Accreditation and Quality, June 1, 2018

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 With the renewed focus on ligature and self-harm, facilities need to undergo a complete reassessment of the physical environment where patients with behavioral or mental health problems are cared for. That goes especially for emergency departments. Annually, 460,000 emergency department visits occur following cases of self-harm, and those patients are six times more likely to make another suicide attempt in the future. 

To prevent patients from further harming themselves, staff should start each shift by reviewing emergency department rooms designated for treatment of behavioral health patients to remove any items patients could use in a suicide attempt. 

For example, there’s a case where a World War II POW committed suicide by hitting himself in the head with an empty metal canteen after days without water. While that happened in the hold of a Japanese prison boat, not a hospital, it highlights how resourceful a suicidal person can be when it comes to finding ways to self-harm. In a hospital setting, earbud cords, compact mirrors, trash bags, bed frames, IV tubing, socks, and much more can be used to attempt suicide.

You may want to use a checklist (see below) to ensure no items are overlooked. In rooms that can’t be completely cleared of ligatures or other instruments for self-harm, facilities should have trained one-on-one observers available to keep patients safe.

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