Waltham Infusion/CATCR, Boston Children's Hospital, Boston, MA, USA.
Nurse Scientist Satellite Services, Boston Children's Hospital, Boston, MA, USA.
J Pediatr Nurs. 2021 Jul-Aug;59:1-9. doi: 10.1016/j.pedn.2020.12.011. Epub 2020 Dec 30.
Suicide rates are increasing for youths and suicide is the second leading cause of death for 10-24 year olds. This evidence-based practice project critically reviews literature regarding the effectiveness of pediatric suicide screening.
A literature search was guided by the following question: In pediatric patients, does suicide screening at every health encounter compared to an annual screen increase clinician identification of patients at-risk. Ten articles met inclusion criteria and were critically appraised and synthesized.
Youths had high rates of suicidal ideation (SI), anxiety, and depression. Pediatric universal suicide screening identified SI in youths with both psychiatric and non-psychiatric medical complaints. Patients with chronic health conditions reported higher rates of mental health symptoms and SI. A specific suicide screening instrument should be used as general mental health screens likely miss youths at-risk for SI. The Ask Suicide-Screening Questions tool is an easy to use and highly sensitive instrument for detecting suicide risk in youths.
Many youths that screen positive for SI do not have known mental health concerns and would have been missed if not asked directly. Universal screening for SI identifies at-risk youth and allows nurses and other providers to intervene. The need for universal screening across pediatric health care settings using brief, validated screening tools is paramount.
Nurses working in pediatric settings should champion universal screening for SI. Unit-based quality improvement projects using the Plan-Do-Study-Act change cycle provides a model for instituting universal screening for SI.
青少年的自杀率正在上升，自杀是 10-24 岁人群的第二大死因。本循证实践项目批判性地回顾了关于儿科自杀筛查有效性的文献。
文献检索的问题如下：在儿科患者中，与每年筛查相比，每次就诊时进行自杀筛查是否会增加临床医生识别有风险患者的能力。符合纳入标准的 10 篇文章进行了批判性评价和综合。
青少年有很高的自杀意念（SI）、焦虑和抑郁发生率。儿科普遍自杀筛查在有精神和非精神医学投诉的青少年中发现了 SI。患有慢性健康状况的患者报告有更高的心理健康症状和 SI 发生率。应使用特定的自杀筛查工具，因为一般的心理健康筛查可能会遗漏有 SI 风险的青少年。Ask Suicide-Screening Questions 工具是一种易于使用且高度敏感的工具，可用于检测青少年的自杀风险。
许多 SI 筛查呈阳性的青少年没有已知的心理健康问题，如果不直接询问，这些青少年可能会被遗漏。普遍筛查 SI 可识别有风险的青少年，并允许护士和其他提供者进行干预。在儿科医疗保健环境中使用简短、经过验证的筛查工具进行普遍筛查至关重要。
在儿科环境中工作的护士应倡导 SI 的普遍筛查。使用计划-执行-研究-行动变更周期的基于单位的质量改进项目为实施 SI 普遍筛查提供了模式。
