Discussion and Conclusion
A practice guideline for nursing care of suicidal patients with schizophrenia or related psychotic disor- ders was developed and tested. The guideline is grounded in available evidence about risk manage- ment and best practice interventions to reduce suicide risk. Using the assessments included in the guideline assures that all issues relevant to suicide risk are coveredwhendiscussingsuicidalitywithapatient.The level of detail of these assessments exceeds standard questions about suicidality. They allow for an open discussion with the patient, with ample opportunity for the patient to discuss personal experiences. The guideline furthermore discusses interventions to reduce suicide risk and improve the patient’s quality of life. The results of the pilot study show the potential of the guideline to support nurses in discussing suicidal- ity with patients and assessing suicide risk, and to a lesser extent, the potential to support selection and execution of interventions. The level of experience of the nurses who participated in the pilot study was quite high. This may explain why some of the partici- pating nurses experienced the guideline as nothing new. It is possible that the guideline makes explicit whatsomenursesalreadydobasedonexperience.The guideline received less support for selection and execution of interventions, which may be a result of having had few opportunities to develop an interven- tion plan based on the guideline. According to the nurses, the main reason for these few opportunities was the perceived absence of suicidality among patients that were in care during the pilot study. In addition, the majority of nurses in one institution had tod raw from the same pool of patients ,whichreduced the number of candidates.
Discussion and ConclusionA practice guideline for nursing care of suicidal patients with schizophrenia or related psychotic disor- ders was developed and tested. The guideline is grounded in available evidence about risk manage- ment and best practice interventions to reduce suicide risk. Using the assessments included in the guideline assures that all issues relevant to suicide risk are coveredwhendiscussingsuicidalitywithapatient.The level of detail of these assessments exceeds standard questions about suicidality. They allow for an open discussion with the patient, with ample opportunity for the patient to discuss personal experiences. The guideline furthermore discusses interventions to reduce suicide risk and improve the patient’s quality of life. The results of the pilot study show the potential of the guideline to support nurses in discussing suicidal- ity with patients and assessing suicide risk, and to a lesser extent, the potential to support selection and execution of interventions. The level of experience of the nurses who participated in the pilot study was quite high. This may explain why some of the partici- pating nurses experienced the guideline as nothing new. It is possible that the guideline makes explicit whatsomenursesalreadydobasedonexperience.The guideline received less support for selection and execution of interventions, which may be a result of having had few opportunities to develop an interven- tion plan based on the guideline. According to the nurses, the main reason for these few opportunities was the perceived absence of suicidality among patients that were in care during the pilot study. In addition, the majority of nurses in one institution had tod raw from the same pool of patients ,whichreduced the number of candidates.
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