自杀风险管理方案在综合医院住院患者中的应用

Application of suicide prevention program in suicide risk management among hospitalized patients

目的探讨自杀风险管理方案在综合医院住院患者中的应用。方法分析54例住院患者自杀的原因,从患者、医护人员、组织管理3方面制订并实施综合医院住院患者自杀风险管理方案,包括成立自杀预防小组,分析住院患者自杀原因、开展患者自杀预防教育,加强医护人员自杀知识和心理干预技能的培训,改善住院患者物理环境,制订自杀预防及处理应急预案。结果 2016年1月—2017年12月,共举办患者心理护理、自杀预防会议12次,共1 600余例患者及家属参加学习。开设自杀预防健康教育宣传栏12次,开展全院护士心理护理、自杀预防培训8次,共2 000余名医护人员参加。召开全院患者自杀事件案例分析讨论会10次,自杀预防相关知识专题讲座5次,对病房窗户、刀具、药品检查20次,召开高危科室患者自杀事件案例讨论会8次,患者自杀预防多学科协作会议4次。方案实施后,患者自杀行为发生率从5.0/10万下降至2.3/10万,成功预防自杀行为4例。结论自杀风险管理方案的实施,加强了对患者心理健康、自杀预防的教育,增强了护士对患者自杀防范意识和风险管理能力,制订了系统规范化的自杀预防管理措施,达到了减少患者自杀事件发生和保障患者安全的目的。

Objective To explore the effects of application of suicide prevention program for suicide risk management among hospitalized patients. Methods We analyzed causes of suicide with 54 hospitalized patients,designed and implemented suicide prevention program in general hospitals from three aspects：patients,medical staff, and organization management. The program included establishing suicide prevention team,conducting education on patients＇ mental health and suicide prevention,strengthening training of medical staff,formulating patient suicide prevention regulations,improving hospitalized patients＇ humanistic and physical environment,and strengthening muhidisciplinary teamwork. Results After the implementation of the program,a total of 12 sessions of psychological care and suicide prevention meetings were held. A total of 1,600 patients and their family members participated in the study. Health education bulletin for suicide prevention was set up 12 times. Nurses in the hospital received psychological nursing and suicide prevention training for 8 times,with more than 2,000 medical staff participating. The hospital held 10 seminars for case analysis about suicidal incidents and 5 suicide prevention related lectures. Examinations of cutlery,doors and windows,and medicine in wards were conducted for 20 times. Case discussion meetings on suicide incidents in high-risk departments were held for 8 times. Multidisciplinary collaboration meetings were conducted for 4 times. Conclusion The implementation of suicide prevention program strengthened patients＇ mental health and suicide prevention education,enhanced nurses＇ awareness on suicide prevention and risk man- agement ability,formulated standardized system of suicide prevention management measures,and reached the goals of suicide prevention and patient safety.