The guideline, Nursing Care of Suicidal Patients with
Schizophrenia or Related Psychotic Disorders, consists of:
(a) part A: theoretical background and recommendations,
(b) part B: data collection and interventions, (c)
basic suicidality assessment (SA), and (d) advanced
SA. Parts A and B provide background information
and instructions for usage. The basic SA and advanced
SA are working documents that nurses can use in clinical
practice. In order to meet current standards, the
guideline was set up to comply with the AGREE instrument
for the appraisal of guidelines (The AGREE
Collaboration, 2001).
Part A of the guideline is predominantly derived
from the Practice Guideline for the Assessment and Treatment
of Patients with Suicidal Behaviors (American Psychiatric
Association, 2003) and provides information on
risk factors for suicide in the general population, risk
factors for suicide in patients with schizophrenia, and
on psychiatric management of patients who suffer
from suicidality. Part A concludes with general recommendations
for clinical practice. In part B, these recommendations
are translated into a guideline specifically
for nursing practice. Part B describes the underlying
principles and conditions in order to use the basic SA
and the advanced SA effectively. Furthermore, part B of
the guideline describes how suicide risk is evaluated
from the information collected and how nurses can
intervene to reduce the risk for suicide and improve
the patient’s quality of life.
The basic SA and advanced SA are constructed
around the evidence-based risk factors and protective
factors for suicide as described in part A of the guideline.
Nurses are encouraged to discuss suicidality
openly, with an accepting and empathic attitude
(American Psychiatric Association, 2003; Talseth et al.,
1999), and patients must feel that speaking about suicidality
is acceptable and can be done without fear of
judgment. From the notion that nurses should be nonjudgmental
follows that suicide should not be completely
rejected as an option to the patient. The