Department of Psychiatry, University of California San Diego School of Medicine, La Jolla, CA, USA.
Department of Psychiatry and University of California San Diego Health Risk Management, University of California San Diego School of Medicine, La Jolla, CA, USA.
Worldviews Evid Based Nurs. 2020 Feb;17(1):24-31. doi: 10.1111/wvn.12418.
We now know that nurses are at greater risk for suicide than others in the general population. It is known that job stressors are prevalent in nurses who die by suicide. Yet, little is known about targeted suicide prevention for nurses. The first nurse-centric Healer Education Assessment and Referral (HEAR) suicide prevention program was piloted for 6 months in 2016. The HEAR program was effective in identifying at-risk nurses.
The purpose of this paper is to report the 3-year sustainability and outcomes of this nurse suicide prevention program.
Descriptive statistics are provided of program outcomes over the course of 3 years.
Over the 3 years, 527 nurses have taken advantage of the screening portion of the program. Of these, 254 (48%) were Tier 1 high risk, and 270 (51.2%) were Tier 2 moderate risk. A startling 48 (9%) had expressed thoughts of taking their own life, 51 (9.7%) had a previous suicide attempt, whereas only 79 (15%) were receiving counseling or therapy. One hundred seventy-six nurses received support from therapists electronically, over the phone, or in person; 98 nurses accepted referral for treatment. The number of group emotional debriefs rose from eight in 2016 to 15 in 2017 to 38 in fiscal year 2019. Many of the debriefs are now requested (vs. offered), demonstrating the development of a culture open to reaching out for mental health treatment.
The initial success of this pilot program has been sustained. A nurse suicide prevention program of education, assessment, and referral is feasible, well-received, proactively identifies nurses with reported suicidality and facilitates referral for care. The HEAR program has provided service to physicians and residents for 10 years and now supports effectiveness in nurses. The HEAR program is portable and ready for replication at other institutions.
我们现在知道，护士自杀的风险比普通人群中的其他人更高。已知工作压力源在自杀身亡的护士中很普遍。然而，针对护士的有针对性的自杀预防措施知之甚少。第一个以护士为中心的治疗师教育评估和转介（HEAR）自杀预防计划于 2016 年试行 6 个月。HEAR 计划在识别高危护士方面非常有效。
本文旨在报告该护士自杀预防计划的 3 年可持续性和结果。
提供了该计划 3 年来的项目成果描述性统计数据。
在 3 年期间，有 527 名护士利用了该计划的筛查部分。其中，254 名（48%）为一级高危，270 名（51.2%）为二级中危。令人震惊的是，有 48 名（9%）表示有自杀念头，51 名（9.7%）曾有自杀企图，而只有 79 名（15%）正在接受咨询或治疗。176 名护士通过电子方式、电话或亲自获得治疗师的支持；98 名护士接受了治疗转介。小组情绪疏导的数量从 2016 年的 8 次增加到 2017 年的 15 次，再到 2019 财年的 38 次。许多情绪疏导现在是由护士主动要求的（而不是提供的），这表明心理健康治疗方面的文化已经开始开放。
该试点计划的初步成功得以维持。教育、评估和转介的护士自杀预防计划是可行的、受欢迎的，能够主动识别有报告自杀倾向的护士，并为其提供护理转介。HEAR 计划已经为医生和住院医师提供了 10 年的服务，现在也支持护士的效果。HEAR 计划具有便携性，随时可以在其他机构复制。
