*Foot & Ankle Specialists of the Mid-Atlantic, Wheaton, MD.
†National Institute of Mental Health, Bethesda, MD.
J Am Podiatr Med Assoc. 2022 May-Jun;112(3). doi: 10.7547/21-062.
Despite prevention efforts, suicide rates continue to rise, prompting the need for novel evidence-based approaches to suicide prevention. Patients presenting with foot and ankle disorders in a podiatric medical and surgical practice may represent a population at risk for suicide, given risk factors of chronic pain and debilitating injury. Screening has the potential to identify people at risk that may otherwise go unrecognized. This quality improvement project aimed to determine the feasibility of implementing suicide risk screening in an outpatient podiatry clinic and ambulatory surgical center.
A suicide risk screening quality improvement project was implemented in an outpatient podiatry clinic and ambulatory surgical center in collaboration with a National Institute of Mental Health suicide prevention research team. Following training for all staff, patients aged 18 years and older were screened for suicide risk with the Ask Suicide-Screening Questions as standard of care. Clinic staff were surveyed about their opinions of screening.
Ninety-four percent of patients (442 of 470) agreed to be screened for suicide risk and nine patients (nine of 442 [2%]) were screened as nonacute positive; zero patients were screened as acute risk. The majority of clinic staff reported that they found screening acceptable, felt comfortable working with patients who have suicidal thoughts, and thought screening for suicide risk was clinically useful.
Suicide risk screening was successfully implemented in an outpatient podiatry clinic. Screening with the Ask Suicide-Screening Questions instrument provided valuable information that would not have been ascertained otherwise, positively impacting clinical decision-making and leading to improved overall care for podiatry patients.
尽管采取了预防措施，但自杀率仍在上升，这促使我们需要寻求新的基于证据的自杀预防方法。在足病医学和外科实践中出现足部和踝关节疾病的患者，由于存在慢性疼痛和使人衰弱的伤害等风险因素，可能代表着一个有自杀风险的人群。筛查有可能识别出那些可能未被发现的有风险的人。本质量改进项目旨在确定在门诊足病诊所和门诊手术中心实施自杀风险筛查的可行性。
与美国国立精神卫生研究院自杀预防研究小组合作，在一家门诊足病诊所和门诊手术中心实施了自杀风险筛查质量改进项目。在对所有工作人员进行培训后，按照标准护理对 18 岁及以上的患者进行自杀风险 Ask Suicide-Screening Questions 筛查。诊所工作人员对他们对筛查的看法进行了调查。
94%的患者（442/470）同意接受自杀风险筛查，9 名患者（442 名中的 9 名[2%]）筛查为非急性阳性；无急性风险患者被筛查出。大多数诊所工作人员报告说，他们发现筛查是可以接受的，与有自杀念头的患者一起工作感到舒适，并且认为自杀风险筛查在临床上是有用的。
在一家门诊足病诊所成功实施了自杀风险筛查。使用 Ask Suicide-Screening Questions 工具进行筛查提供了有价值的信息，否则这些信息将无法获得，这对临床决策产生了积极影响，并改善了足病患者的整体护理。
