提昇住院病人自殺風險篩檢正確率之改善專案

背景：本單位曾發生病人自殺案件，會同專家歸納出標準作業流程不完善、缺乏在職教育、網路設備效能不佳三大原因。且80%的病人自殺事件是缺乏適當的自殺風險篩檢與轉介評估。有深入探討之必要性。目的：提升自殺風險篩檢正確率。方法：制定院內病人自殺風險個案處理流程、發展自殺篩檢在職教育、修訂自殺通報標準，如：住院病人之自殺風險篩檢評估分數大於等於10分或自殺想法大於等於2分，需即刻執行「住院病人自殺風險個案處置流程」，並將人工通報轉為資訊系統直接通知，並與精神科團隊共同照護，進而推廣至全院，跨領域共同合作。結果：住院自殺風險篩檢正確率由35.7%上升至100%。結論：希望本專案可提供臨床參考，能提升自殺風險篩檢正確率，進而有效降低住院病人自殺風險。

關鍵字

住院病人；自殺風險篩檢；自殺防治

並列摘要

Background: A previous study showed that 80% of patient suicide incidents resulted from the lack of adequate suicide risk assessments. Purpose: To improve suicide risk screening accuracy Methods: To address the above issues, a project consisting of the following strategies for the improvement of suicide risk assessment accuracy was adopted: The development of SOPs for inpatient suicide management, the organization of suicide assessment training courses for healthcare professionals, amendments on suicide report thresholds (i.e. the ＂SOPs for inpatient suicide management＂ should be activated once inpatients with suicide risk assessment score ≧10 points or suicide ideation ≧2 points were detected), the paradigm shift in reporting systems (from staff-based report to management information system (MIS)-based report), better collaboration with the psychiatric team, and promotion of hospital-wide practice. Results: The results showed that the accuracy of inpatient suicide risk assessment increased from 35.7% to 100%. Conclusion: The ultimate goal is to use this project as a clinical reference, enhance the accuracy of suicide risk assessment, and thus achieve effective inpatient suicide prevention.

並列關鍵字

Inpatient ； suicide risks ； suicide prevention

參考文獻

Williams, S. C., Schmaltz, S. P., Castro, G. M., & Baker, D. W. (2018). Incidence and method of suicide in hospitals in the United States. The Joint Commission, 44(11), 643-650.

李明濱(2009)．心情溫度計(一版)．台北市：全國自殺防治中心。