Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
Hung YY(1), Sip YL(1), Lam YL(1), Lee TK(1)
Affiliation :
(1) Department of Psychiatry, Tai Po Hospital
Introduction :
NGASR is a suicidal risk assessment tool used by psychiatric nurses across 7 clusters for more than 10 years. It provides a structured framework for nurses to screen psychiatric patients’ suicidal risks in inpatient settings. Although the author who developed NGASR had offered some elaborations for the empirical evidence and rationale to support the tool’s 15 key indicator variables, throughout the years there had been ongoing comments for NGASR’s lacking of clear instructions to guide the administering, leading to difficulties among nurses to score the variables for different scenarios, which causing inconsistency for the risk screening and hindering appropriate nursing management. An in-house reference would be needed to address the aforementioned concern.
Objectives :
Develop an in-house reference to guide scoring in NGASR; optimize consistency among nurses in administering NGASR.
Methodology :
The exercise consisted of 3 phases. First, an in-house reference guide for scoring in NGASR was developed by a task-force by making reference to author’s article and other literature. Then, the guide was scrutinized by nursing managers in focused meetings email circulation. Secondly, the task-force held briefing sessions to nurses to introduce the guide. Third, inter-rater reliability evaluation was done by adopting method of a German NGASR inter-rater reliability study. Twenty inpatients nurses (10% of total inpatient nurses) were randomly selected by computer and invited to a meeting room in hospital. A 1-hour briefing of the guide was provided and then nurses were distributed with a same set of case summaries (consisted of 12 different cases with personal data removed). Subsequently, they were asked to conduct NGASRs for the 12 cases within 2 hours. Upon completion, nurses needed to return NGASRs in sealed envelopes. SPSS 29 was used for data analysis.
Result & Outcome :
The in-house reference guide was developed in 6/2023. From 6/2023 to 9/2023, total of 5 briefing sessions on the guide were organized to nurses. The inter-rater reliability evaluation was held on 8/8 and 12/9 with 20 inpatients nurses participated. The Kappa values of all items in NGASR ranged from 0.85 to 1, in which the overall total Kappa is 0.965, indicating that nurses had strong agreement in using NGASR. To conclude, the in-house reference guide is effective to optimize consistency among nurses in administering NGASR.
