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 for Disease Control, in 2007 suicide was the tenth leading cause of death (third most in young people) in the U.S., accounting for 34,598 deaths. The overall rate was 11.3 suicide deaths per 100,000 people. An estimated 11 attempted suicides occur per every suicide death. Suicide was the third leading cause of death for young people ages 15 to 24. Of every 100,000 young people in each age group, the following number died by suicide: Children ages 10 to 14 — 0.9 per 100,000
Adolescents ages 15 to 19 — 6.9 per 100,000
Young adults ages 20 to 24 — 12.7 per 100,000
Older Americans are also disproportionately likely to die by suicide. Of every 100,000 people ages 65 and older, 14.3 died by suicide in 2007. (CDC, 2010) Suicide is the result of an untreated mental illnesses, severe mental illnesses usually where the patient is noncompliant, substance abuse, and physical or sexual abuse. These diagnoses make suicide the taboo of our society and suicide attempts are frowned upon and ignored in families instead of this being a time of healing, increased communication, education and awareness of symptoms the opposite occurs escalating the problem. This disgrace of a suicide attempt is a time of silence instead of a time of rapport with friends and family members. Research has shown that adults and women who die by suicide are likely to have seen a primary care provider in the year before death; improving primary-care providers' ability to identify and treat risk factors that may help prevent suicide among these groups (Luoma, Pearson, & Martin, 2002). According to the National Institute of Mental Health 50% of all suicide victims visit a doctor the month before their death (Anderson 2007). In the general hospital setting, hospitals have been required, long before safety goal 15, identifying individuals at risk was a national safety goal, to monitor suicidal patients. General hospitals have done this differently, some gave patients a low...
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