Risk management tools in the insurance of suicidal patients in hospital emergencies

Authors

DOI:

https://doi.org/10.33448/rsd-v12i1.39776

Keywords:

Risk management; Suicide; Patient Safety; Hospitalization; Suicide attempt.

Abstract

Objectives: To identify risk management tools for the safety of patients with suicidal behavior, used in hospital emergencies. Methodology: Integrative literature review, from 2017 to 2021, in order to answer the research's guiding question: What are the management tools used in risk management and patient safety in suicidal behavior in the hospital environment? The PICO search strategy was used and the selection of studies was carried out independently by two reviewers, who used Scopus, Web of Science and Pubmed databases as search sources. Results: 863 articles were identified, of which 8 were selected. It was observed in the studies that the management tools were: Service protocols; Failure Mode and Effects Analysis in Healthcare (HFMEA); Checklist and the Safety Huddle. Conclusions: Risk management tools for the safety of patients with suicidal behavior used in hospital emergencies show positive results in relation to suicide prevention in these environments and that contribute to quality and safe care, but lack more scientific evidence.

References

Abi, A. X. C. F., Cruz, E. D. A., Pontes, L., Santos, T., & Felix, J. V. C. (2022). The Healthcare Failure Mode and Effect Analysis as a tool to evaluate care protocols. Rev Bras Enferm., 75(3):e20210153. https://doi.org/10.1590/0034-7167-2021-0153

Alarcón-Gil, M. T., Toro, S. O., & Baena-Caldas, G. P. (2019). The evidence-based medicine PICO strategy applied to dentistry using MeSH, Emtree and DeCS. Rev Fac Odontol Univ Antioq., 31(1-2):91-101. http://dx.doi.org/10.17533/udea.rfo.v31n1-2a8

Andrade, J. A., Jesus, R. C. R. S., Almeida, L. A. H., Jesus, D. P. V., Menezes, A. A., & Duque, A. M. (2021). Tentativa de suicídio: análise de pacientes atendidos em uma unidade hospitalar. Com. Ciências Saúde., 32(3):137 144. https://doi.org/10.51723/ccs.v32i03.937

Baldaçara, L., Grudtner, R. R., Leite, V. S., Porto, D. M., Robis, K. P., Fidalgo, T. M., Rocha, G. A., Diaz, A. P., Meleiro, A., Correa, H., Tung, T. C., Malloy-Diniz, L., Quevedo, J., & Silva, A. G. da. (2021). Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 2. Screening, intervention, and prevention. Brazilian J Psychiatry., 43(5):538–549. https://doi.org/10.1590/1516-4446-2020-1108

Baldaçara, L., Rocha, G. A., Leite, V. S., Porto, D. M., Grudtner, R. R., Diaz, A. P., Meleiro, A., Correa, H., Tung, T. C., Quevedo, J., & Silva, A. G. da. (2021). Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 1. Risk factors, protective factors, and assessment. Braz J Psychiatr., 43(5):525-537. https://doi.org/10.1590/1516-4446-2020-0994

Brezo, J., Paris, J., Tremblay, R., Vitaro, F., Zoccolillo, M., Hebert, M., & Turecki, G. (2006). Personality traits as correlates of suicide attempts and suicidal ideation in young adults. Psychological Medicine, 36(2), 191–202. https://doi.org/10.1017/S0033291705006719.

Changchien, T. C., Yen, Y. C., Wang, Y., J., Chang, Y. C., Ju, R. S., Yen, P. F., Cheng, Y. T., Shih, M. L., & Huang, Y. H. (2019). Establishment of a comprehensive inpatient suicide prevention network by using health care failure mode and effect analysis. Psychiatr Serv., 70(6):518–521. https://doi.org/10.1176/appi.ps.201700512.

Daniel, S. S., Goldston, D. B., Erkanli, A., Franklin, J. C., & Mayfield, A. M. (2009). Trait anger, anger expression, and suicide attempts among adolescents and young adults: a prospective study. J Clin Child AdolescPsychol., 38(5):661–671. https://doi.org/10.1080/15374410903103494

Decou, C. R., Huppert, T., Kume, K., Veras, P., Comtois, K. A., & Rea, T. (2021). Prehospital patient care protocols for suicidality in Washington State. Prehosp Emerg Care., 25(3):432-437. https://doi.org/10.1080/10903127.2020.1771489

Donovan, A. L., Aaronson, E. L., Black, L., Fisher, S. A., Bird, S. A., Benzer, T., & Temin, E. S. (2021). Keeping Patients at Risk for Self-Harm Safe in the Emergency Department: A Protocolized Approach. The Joint Commission. Jt. Comm. J. Qual., 47(1):23–30. https://doi.org/10.1016/j.jcjq.2020.08.013

Frost, D. A., Snydeman, C. K., Lantieri, M. J., Wozniak, J., Bird, S., & Stern, T. A. (2020). Development and Implementation of a Suicide Prevention Checklist to Create a Safe Environment. Psychosomatics., 61(2):154-160. https://doi.org/10.1016/j.psym.2019.10.008

Gawande, A. (2009). The Checklist Manifesto: How to Get Things Right. 1ª ed. New York: Metropolitan Books of Henry Holt and Company.

Gomes, J. de L., Sá, I. P. G. de., Pereira, G. C., Ribeiro, W. A., Santos, L. C. A. dos., Paula, E. de., Lima, D. S., Castro, K. de., Júnior, J. C. F., Morais, M. C. de., Martinho, M. N., & Arnaldo, C. R. de O. (2022). Contributos da enfermagem à pessoa com conduta suicida na emergência: Um desafio no cotidiano . Research, Society and Development, [S. l.], v. 11, n. 6, p. e38511629276. https://doi.org/10.33448/rsd-v11i6.29276.

Gray, N. S., John, A., McKinnon, A., Raybould, S., Knowles, J., & Snowden, R. J. (2021). Structured Professional Judgment to Assist the Evaluation and Safety Planning of Suicide Risk: The Risk of Suicide Protocol (RoSP). Front Psychiatry., 12(607120):1-9. https://dx.doi.org/10.3389%2Ffpsyt.2021.607120

Joint Commission. (2017). Perspectives preview: special report: suicide prevention in health care settings. https://www.jointcommission.org/issues/article.aspx?Article=GtNpk0ErgGF%2b7J9WOTTkXANZSEPXa1%2bKH0%2f4kGHCiio%3d

Júnior, A. A. M. F., Flores, E. P. G. S. S., Fontenele, N. A. O., & Costa, M. M. (2021). Construção de um protocolo para identificação de risco de suicídio em idosos. Revista Tendências da Enfermagem Profissional. Ceará., 13(2). http://www.coren-ce.org.br/wp-content/uploads/2021/06/Revista-13-06-2021.pdf#page=16.

Lima, L. A., Silva, L. C. M. A., Dantas, J. K. S., Lima, M. S. M., Dantas, D. V., & Dantas, R. A. N. (2021). Root cause analysis, failures and effects in pediatric total quality management: a scoping review. Rev Bras Enferm., 74(6):e20200954. https://doi.org/10.1590/0034-7167-2020-0954

Mello, L. R. G., Christovam, B. P., Araujo, M. C., & Moreira, A. P. M. (2020). Implementação da metodologia Safety Huddle na terapia intensiva durante a pandemia COVID-19: Relato de Experiência. Enferm. Foco., 11(1):222-227. http://dx.doi.org/10.21675/2357-707X.2020.v11.n1.ESP.3528

Melnyk, B. M., & Fineout-Overholt, E. (2015). Making the case for evidence-based practice. In: Melnyk BM, Fineout-Overholt E. Evidence-based practice innursing & healthcare. A guide to best practice. Philadelphia: Lippincot Williams & Wilkins.

Mendes, K. D. S., Silveira, R. C. C. P., & Galvão, C. M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na Enfermagem. Texto Contexto Enferm., 17(4):758-764. https://doi.org/10.1590/S0104-07072008000400018.

Mendes, K. D. S., Silveira, R. C. C. P., & Galvão, C. M. (2019). Uso de gerenciador de referências bibliográficas na seleção dos estudos primários em revisão integrativa. Texto & Contexto Enfermagem., 28:e20170204. https://dx.doi.org/10.1590/1980-265X-TCE-2017-0204

Miranda, A. L., Oliveira, A. L. L., Nacer, D. T., & Aguiar, C. A. M. (2016). Resultados da implementação de um protocolo sobre a incidência de Infecção do Trato Urinário em Unidade de Terapia Intensiva. Rev Lat Am Enfermagem., 24(e2804):1-9. https://doi.org/10.1590/1518-8345.0866.2804.

Moraes, C. D., Rabin, E. G., & Viegas, K. (2018). Assessment of the care process with orthotics, prosthetics and special materials. Rev Bras Enferm., 71(3):1099-1105. https://doi.org/10.1590/0034-7167-2017-0031

Noelck, M., Campbell, M. V., & Austin, J. P. (2019). A Quality Improvement Initiative to Reduce Safety Events Among Adolescents Hospitalized After a Suicide Attempt. Hosp Pediatr., 9(5):365-372. https://doi.org/10.1542/hpeds.2018-0218

Oliveira, G. C., Schneider, J. F., Santos, V. B. D., Pinho, L. B., Piloti, D. F. W., & Lavall, E. (2017). Cuidados de enfermagem a pacientes com risco de suicídio. Ciênc Cuid Saúde., Abr-Jun;16(2). https://periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/37182/19950

Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. K. (2016). Rayyan – a web and mobile app for systematic reviews. Syst Rev., 5(1):1-10. https://doi.org/10.1186/s13643-016-0384-4.

Pasa, T., Magnano, T. S. B., & Urbanetto, J. S. (2021). Transcultural adaptation of the Healthcare Failure Mode and Effect Analysis (HFMEA) for use em Brazil: preview. Research, Society and Development, v. 10, n.6, e15310615285. https://doi.org/10.33448/rsd-v10i6.15285

Pereira, W. S. B. (2022). Desafios e perplexidades no atendimento de emergência a quem tenta suicídio. Revista Ibero-Americana de Humanidades, Ciências e Educação. São Paulo, v.8.n.06. jun. https://doi.org/10.51891/rease.v8i6.5895

Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database Syst Rev., 6(6):1-40. https://doi.org/10.1002/14651858.cd000072.pub3.

Rothes, I., & Henriques, M. (2018). Health Professionals Facing Suicidal Patients: What Are Their Clinical Practices? Int J Environ Res Public Health., 15(6):1-19. https://dx.doi.org/10.3390%2Fijerph15061210

Sales, C. B., Bernardes, A., Gabriel, C. S., Brito, M. F. P., Moura, A. A., & Zanetti, A. C. B. (2018). Protocolos Operacionais Padrão na prática profissional da enfermagem: utilização, fragilidades e potencialidades. Rev Bras Enferm., 71(1):138–146. https://doi.org/10.1590/0034-7167-2016-0621.

Svensson, J. (2022). Patient Safety Strategies in Psychiatry and How They Construct the Notion of Preventable Harm: A Scoping Review. J Patient Saf., 18(3):245-252. https://doi.org/10.1097/pts.0000000000000885

Tan, R., Hu, D., Han, Y., & Liu, Y. (2018). Characteristics of and management strategies for 54 suicidal inpatients in a general hospital. Frontiers of Nursing., 5(2):139-145. http://dx.doi.org/10.2478/fon-2018-0018.

Vantil, F. C. S. (2017). Gestão de risco na segurança do paciente com transtorno mental. Vitória: Universidade Federal do Espírito Santo. https://repositorio.ufes.br/bitstream/10/8315/1/tese_11132_Dissertac%3fa%3fo_MESTRADO%20EM%20ENFERMAGEM_FERNANDA_CORDEIRO_SIRTOLI_VANTIL.pdf

Vantil, F. C. S., Lima, E. F. A., Figueiredo, K. C., Portugal, F. B., Sousa, A. I., & Primo C. C. (2018). Patient safety with mental disorder: developing management technologies for risk management. Esc Anna Nery., 22(4):1–5. https://doi.org/10.1590/2177-9465-EAN-2017-0307.

Watts, B. W., Shiner, B., Young-Xu, Y., & Mills P. D. (2017). Sustained Effectiveness of the Mental Health Environment of Care Checklist to Decrease Inpatient Suicide. Psychiatric Services., 68(4):405-407. https://doi.org/10.1176/appi.ps.201600080

Williams, S. C., Schmaltz, S., Castro, G. M., & Baker, D. W. (2018). Incidence and method of suicide in hospitals in the United States. Jt Comm J Qual Patient Saf., 44(11):643-650. https://doi.org/10.1016/j.jcjq.2018.08.002

Zhou, E., Decou, C. R., Stuber, J., Rahbar-Rowhani, A., Kume, K., & Rivara, F. P. (2020). Usual care for Emergency Department patients who present with suiciderisk: A survey of hospital procedures in Washington state. Arch Suicide Res., 24(3):342–354. https://doi.org/10.1080/13811118.2019.1635932

Published

11/01/2023

How to Cite

WANSING, G. B.; BLATT, C. R.; CABRERA, L. C. P. .; LACCHINI, A. J. B. . Risk management tools in the insurance of suicidal patients in hospital emergencies. Research, Society and Development, [S. l.], v. 12, n. 1, p. e27512139776, 2023. DOI: 10.33448/rsd-v12i1.39776. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/39776. Acesso em: 27 jan. 2023.

Issue

Section

Health Sciences