Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Chan SY(1)(2), Leung WK(1), Ng WM(1), Pang MC (1), Leung RYY(1)(3), Chan WS(1)(4), Lee SL(1)(5)
Affiliation :
(1) Quality and Safety (2) Department of Clinical Oncology (3) Department of Pathology (4) Department of Medicine (5) Department of Paediatrics & Adolescent Medicine, Queen Mary Hospital
Introduction :
Suicide is a significant public health concern worldwide, with in-patient suicide being a particularly critical issue. Despite the implementation of standard risk assessment, the prediction and prevention of in-patient suicide remain challenging.
Objectives :
The primary objective of this pilot study is to investigate the effectiveness of modified Geriatric Depression Scale (GDS-4) assessment tool in identifying suicide risk among in-patients. The secondary objective is to collect the user feedback on the assessment tool, explore the feasibility and acceptability of implementing the additional assessment tool in routine clinical practice.
Methodology :
This cross-sectional study was conducted from 11th November 2022 to 12th December 2022. It involved all in-patients admitted to 8 high-risk wards of clinical oncology, medicine, surgery and orthopaedic in Queen Mary Hospital. A modified version of the GDS-4 was used as an adjunct tool and was designed to provide further insight into standard suicide risk assessment. Ward nurses conducted face-to-face interviews using both the standard suicide risk assessment and the additional assessment tool upon admission. If suicide risk was identified, suicide precaution and monitoring were initiated, and the attending physician was immediately informed with appropriate clinical referral made. Feedback was collected from the staff at the end of the study.
Result & Outcome :
This study has analysed 596 cases, with a demographic of 60% male and 40% female, aged 14-100. The study identified 15 cases (2.52%) with suicide risk, with 7 cases expressing suicidal ideation during standard risk assessment upon admission. The modified GDS-4 assessment tool further identified an additional 8 cases with suicidal risk. Most cases (86.7%) were cancer patients, and majority (93.3%) had adjustment reaction and emotional disturbance. Twelve cases were referred to clinical psychologist and 2 cases required psychiatric consultation. The main contributing factors were pain, insomnia, and poor appetite. Staff feedback from 33 evaluation forms indicated that 90.9% agreed the additional assessment tool facilitated early detection of potential suicide risk, short time spent on assessment (less than 5-10 minutes) and was generally acceptable to most patients. The additional assessment tool could be a valuable addition to standard risk assessment on the early detection of patient with suicidal risk, potentially improving patient safety and outcomes.
