University of Dundee, Dundee, UK
University of Dundee College of Medicine Dentistry and Nursing, Dundee, UK.
BMJ Open Qual. 2024 Sep 17;13(3):e002718. doi: 10.1136/bmjoq-2023-002718.
Scotland's 2022 suicide prevention strategy recommends building skills and knowledge among healthcare staff who play a role in preventing suicide. A quality improvement project (QIP) in relation to this was initiated because several patients attending dental appointments disclosed suicidal thoughts and/or plans to attempt death by suicide. Dental staff and students involved expressed feeling ill-equipped at how to manage this situation. This initial QIP aimed to establish routine screening, identification and signposting of dental outpatients identified as having an increased risk of suicide during attendance at any dental clinic within the Dental Hospital. Several Plan-Do-Study-Act (PDSA) cycles ensued. First, to understand the problem, a scoping literature search on the role of dental professionals in preventing suicide and the availability of suicide risk awareness training frameworks for non-medical healthcare staff revealed few publications and no identified training frameworks. This was PDSA1. To gain insight into the local culture in relation to the QIP aims, two further cycles were undertaken. These examined whether dental patients were routinely screened for mental health conditions, and dental staff and student attitudes. Screening activity was measured, a new medical history intervention was implemented and a significant improvement in the number of patients being screened was seen (PDSA2). At the time of writing, the newly introduced medical history form is now used routinely to screen all outpatients attending the Dental Hospital, where 60 000 outpatients' appointments are delivered annually. PDSA3 sought dental staff and student views on whether suicide risk awareness is part of their role. This found suicide risk awareness is considered part of the dental professionals' role, but a lack of training, and a desire for training was expressed. With no suitable training frameworks, PDSA4 aimed to design, implement and evaluate a pilot training educational intervention by a clinical psychologist. Sixteen dental care professionals attended the workshop. To measure training effectiveness, participants completed pre-training (baseline) and post-training questionnaires to assess their self-efficacy around suicide awareness. Improvements in self-efficacy following training occurred across all domains, demonstrating a successful intervention which can be upscaled.
苏格兰的 2022 年预防自杀策略建议在参与预防自杀的医疗保健人员中培养技能和知识。鉴于在牙科预约中就诊的一些患者透露了自杀念头和/或企图自杀的计划,启动了与此相关的质量改进项目 (QIP)。参与的牙科工作人员和学生表示,他们不具备如何处理这种情况的能力。该初步 QIP 的目的是在任何牙科诊所就诊期间,确定牙科门诊患者存在自杀风险,并对其进行常规筛查、识别和转介。随后进行了几个计划-执行-研究-行动 (PDSA) 循环。首先,为了了解问题,对牙科专业人员在预防自杀方面的作用以及非医疗保健人员的自杀风险意识培训框架的可用性进行了广泛的文献检索,结果发现发表的文献很少,也没有确定的培训框架。这是 PDSA1。为了深入了解与 QIP 目标相关的当地文化,又进行了两个循环。这些循环检查了牙科患者是否定期接受心理健康状况筛查,以及牙科工作人员和学生的态度。测量了筛查活动,实施了新的病史干预措施,发现接受筛查的患者数量显著增加(PDSA2)。在撰写本文时,新引入的病史表现在已用于常规筛查所有在牙科医院就诊的门诊患者,每年有 60000 名门诊患者的预约。PDSA3 旨在了解牙科工作人员和学生是否认为自杀风险意识是其工作的一部分。结果发现,自杀风险意识被认为是牙科专业人员角色的一部分,但他们缺乏培训,并且表示希望接受培训。由于没有合适的培训框架,PDSA4 旨在由临床心理学家设计、实施和评估一项试点培训教育干预措施。16 名牙科保健专业人员参加了该研讨会。为了衡量培训效果,参与者在培训前(基线)和培训后完成问卷,以评估他们对自杀意识的自我效能感。培训后,所有领域的自我效能感都有所提高,表明这是一项成功的干预措施,可以扩大规模。