Suicide Screening and Risk Assessment in the Emergency Department: Case Review of a Suicide Attempt Survivor.
Avery Z Laliberte, Brandon Roth, Beau Edwards and 1 others
PMID 34479740WHAT IT FOUND
An emergency department record for a homeless veteran showed no documented suicide screening at any visit, even after a suicide attempt and after he reported suicidal thoughts.
This highlights missed risk assessment, not proof of screening outcomes.
Key findings
01No formal suicide screening using valid and reliable instruments was documented during any encounter in the patient's record.
02The patient reported suicidal ideation to social workers, and one documented asking directly about suicidal ideation and suicide planning, but no validated screening was conducted during that stay.
03This is a case review of one patient, so its findings may not generalize to other settings.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a case review of a single patient, so it cannot show how common missed screening is or whether screening would have changed his outcome. The review depended on what was written in the electronic health record, so undocumented screening or risk assessment could not be counted. The record was integrated, but other visits outside the captured range may have been missed. The study period stopped before knowing whether the patient attempted or died by suicide later.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not conclude from this record that universal ED suicide screening is proven effective or that all ED patients are missed. It is a single patient chart review, and it reports documentation gaps, not outcomes.