NURS243 - Chapter 22: Suicide Prevention

Suicide

voluntary act of killing oneself, a fatal, self-inflicted destructive act with explicit or inferred intent to die, sometimes called suicide completion

Suicidality

all suicide-related behaviors and thoughts of completing or attempting suicide and suicidal ideation

Suicidal ideation

thinking about and planning one’s own death

Suicide attempt

nonfatal, self-inflicted destructive act with explicit or implicit intent to die

Parasuicide

voluntary, apparent attempt at suicide, commonly called a suicidal gesture, in which the aim is not death

Lethality

the probability that a person will successfully complete suicide

Suicide Across the Life Span

1. Children, adolescents, and young adults

   • 2nd leading cause of death

2. Adults & Older Adults

   • Major contributor to premature death

   • 4th ranked

   • Peaks during middle age & 75+

Suicide Epidemiology and Risk Factors

1. Physical

2. Psychological

3. Social

4. Gender

5. Sexuality

6. Race & Ethnicity

7. Pandemic Impact

Suicide Biologic theories

• Depression

• Severe childhood trauma

• Genetic factors

Suicide Psychological theories

• Cognitive theories

  • Hopelessness

• Emotional factors

  • personality traits

• Interpersonal

  • Psychological theory of suicidal behavior

• Social Theories

  • Social distress

  • Suicide contagion

  • Economic disadvantage

Family Response to Suicide

• Devasting effects on families

• Inc. risk for suicide if another family if suicide occurs

• Survivors

  • Inc. grief, anxiety, depression, guilt

Treatment and Nursing Care for Suicide Prevention

• Psychiatric Emergency

• Ensure Safety

Assessing Suicide Risk

• Identification of suicidal ideation

• Elicitation of a plan

• Determination of severity of intent

• Evaluation of availability of means

Nursing Interventions for Imminent Risk

• Reconnect pt. to other people and instill hope

• Restore emotional stability and reduce suicidal behavior

• Ensure safety

• Inpatient safety considerations

Nursing Interventions for Biologic Domain

• Physical care of self-inflicted injury

• Medication management

• ECT

Nursing Interventions for Psychological Domain

• Challenge suicidal mindset

• Develop new coping strategies

• Commit to treatment

Nursing Interventions for Social Domain

• Social skills training

• Development of support networks

• Stigma reduction

Evaluation of Short-Term Outcomes

• Maintain pt. safety

• Averting suicide

• Mobilizing pt. resources

Evaluation of Long-Term Outcomes

• Continuum of care

• Maintaining pt. in psych. treatment

• Enabling pt. and family to identify and manage suicidal crises effectively

• Widening pt. support network

Documentation and Reporting

• History, assessment & interventions

• Presence or absence of suicidal thoughts, intent & available means

• Use of drugs, alcohol, prescriptions

• Level of pt. judgement

• Prescribed med. dosage and # of pills dispensed

• Plans for ongoing treatment