Authors (including presenting author) :
Mak KN (1), Ko PS (2), Chiu PC (1), Wong SB (1), Ma CM (1), Ng JSC (1)
Affiliation :
(1) Palliative Care Service, Department of Medicine, Haven of Hope Hospital
(2) Nursing Service Division, United Christian Hospital
Introduction :
Suicidal ideations are common in patients with advanced illnesses due to pain and other distressing symptoms, a sense of helplessness and being a burden to others. Caregivers may also experience significant distress when facing their beloved who wish to hasten death. A continuous quality improvement project was conducted in a palliative care ward in 4Q/2019.
Objectives :
(1) To improve nurses’ competence in risk identification, suicidal assessment, communication and suicide prevention
(2) To ensure a safe environment in the palliative care ward for suicide precaution
(3) To educate caregivers by production of an education pamphlet
Methodology :
The improvement project was composed of three strategies: (1) Two identical suicide prevention workshops were held by a palliative care nurse consultant and an advance practice nurse covering suicide risk assessment, suicide prevention strategies, scenario based learning and role play. Improvement in knowledge of suicide was assessed by 10 true-false questions and participant satisfaction was assessed by an evaluation form. (2) A ward safety environment round was conducted by the palliative care ward manager to identify potential risks and ensure facility-related provisions for prevention of inpatient suicide. A four-item audit form was also created covering suicide prevention guideline and workflow, training and the breakdown list of environmental safety inspection. (3) A suicide prevention pamphlet with input from the palliative care multidisciplinary team was designed.
Result & Outcome :
Twenty-eight nurses completed the workshops. All of them agreed or strongly agreed that the workshop had achieved its objective and enhanced their communication skills and risk identification for suicide prevention. Among the 26 participants who completed the pre- and post-tests, 65% (n = 17) showed improvement in their knowledge of suicide (average total score increased from 7.4 to 9.8). The safety environment round was held with eight nursing staff and two personal care assistants. The environment safety inspection was satisfactory. 100% compliance rate was achieved. All nurses were familiar with suicide precaution guidelines and suicide prevention training was provided to the newly recruited staff. Families of patients with suicidal risks were given an education pamphlet describing the warning signs and risk factors of suicide, “do” and “don’t” and related prevention measures.
It is recommended to hold adequate training to nursing staff and caregivers and regular safety environment round to identify potential risks for suicide prevention in palliative care ward.
