The Joint Commission Added the National Patient Safety Goal: Identifying Individuals at Risk for Suicide

The Joint Commission added the National Patient Safety Goal: Identifying Individuals at Risk for Suicide (NPSG 15.01.01) in 2007. This goal was directed at psychiatric and general hospitals with patients whose primary complaint is an emotional or behavior disorder, including substance abuse (according to DSM). This goal is directed at both types of hospitals for important reasons; (1) general hospitals do not have an environment that is conducive to the protection of individuals who are suicidal, and (2) psychiatric hospitals are constructed to protect individuals who are suicidal but have a high concentration of suicidal individuals and are not always staffed appropriately. This goal has an intent that basic issues related to suicide and mental status assessment are included in patient care and should be applied with the use of an electronic health record. (Anderson, Ridge, Latimer, 2007). It was the Joint Commission’s opinion that identification of individuals at risk for suicide while under the care of or following discharge from a health care organization is an important step in protecting these at-risk individuals (The Joint Commission, 2010). This requirement is applicable in general hospitals or any facility providing hospital services, or practice setting, including the emergency room department but still only applies to patients whose chief compliant is emotional, behavioral, or substance abuse. A patient entering the emergency room with an injury whose secondary complaint is depression or a patient receiving an appendectomy with a history of major depressive disorder, safety goal 15 is not directly applicable and these numbers do not need to be reported to the Joint Commission (Adamski, 2007). Psychiatric hospitals are required to conduct a more detailed screening and assessment as appropriate for every admission.

This was chosen as a national goal because suicide is a major, preventable public health problem. According to the Centers

References: 1. The Joint Commission (2010). Accreditation Program: Behavioral Health Care National Patient Safety Goals (Pre-publication version, Effective July 1, 2010). Retrieved from: http://www.jointcommission.org/NR/rdonlyres/4D0F9019-E4E7-49FD-8191-700688637BB3/0/July2010NPSGs_Scoring_BHC.pdf 2. Anderson, S.C., Ridge, R., Latimer G.E. (2007) Assessing Suicide Risk and Defining Precautions: Evaluating Join Commission Expectations and Implementation Examples Siemens Medical Solutions USA, Inc. website: http://www.medical.siemens.com/siemens/en_US/gg_hs_FBAs/files/IT_Solutions_And_Consulting/Assessing_Suicide_Risk_Defining.pdf 3. National Institute of Mental Health, Suicide in the U.S.: Statistics and Prevention. (2010). (NIH Publication 06-4594) Retrieved from: http://www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-and-prevention/index.shtml 4. Pat Adamski.  (2007). Recognizing the issues behind patient suicide. Nursing Management, 38(5), 10.  Retrieved November 10, 2010, from ProQuest Medical Library. (Document ID: 1272466821). 5. Kee, J.L, Hayes, E.R., McCuistion, Linda E. (2009) Antidepressants and Mood Stabilizers. Pharmacology A Nursing Process Approach. (p.409) Saunders Elsevier, St. Louis, MO. 6. Hagen, L. & Quillen, J. (2010). NPSG#15A: Crafting a Suicide Risk Assessment Policy. Strategies for Nurse Managers.com. Retrived from: http://www.strategiesfornursemanagers.com/ce_detail/202080.cfm 7. The Joint Commission. Inpatient Suicides: Recommendations for Prevention The Sentinel Event Alert. (Issue 7) November 6, 1998. Retrieved from: http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_7.htm 8. Centers for Disease Control, Injury Prevention and Control: Data and Statistics. (2010) 10 Leading Causes of Death 2007. 10 Leading Causes of Non-fatal injury. Retrieved from: http://www.cdc.gov/injury/wisqars/index.html 9. Luoma JB, Pearson JL, Martin CE. Contact with mental health and primary care prior to suicide: a review of the evidence. American Journal of Psychiatry, 2002; 159: 909-16.