Inpatient suicide in the general medical setting : an integrative literature review

Abstract

As many as 69% of individuals who kill themselves visit the Emergency Department (ED) for reasons unrelated to suicide and more than one in ten completed suicides are by individuals who were seen in an ED within two months of dying. Most were not screened for suicide risk (Knesper, 2010). Although 52% of inpatient suicides occur in psychiatric settings, focusing attention on these suicides while ignoring the 48% of suicides occurring in the general hospital units is not addressing the whole of the problem. This review centered around literature pertaining to inpatient suicide in the general hospital setting with a focus on the medical-surgical and emergency departments. Data base search terms selected were "inpatient," "suicide," "impatient suicide emergency department," and "inpatient suicide medical-surgical." Twenty-one articles met the inclusion criteria (i.e., the research was done using adults in the general hospital setting, published after January 1, 2006 in the United States, written in English and was peer reviewed) and six were identified as empirical evidence. These articles were reviewed to evaluate the methodology and clinical application, compared and contrasted for similarities and differences, and patterns and themes were identified and described. After review, these studies demonstrated that nurses can play a key role in reducing suicide rates by identifying patient risk, taking appropriate action, creating a safe environment and empowering nurses to assess, make decisions and follow-up and mandatory reporting. It is clear from the literature surveyed that more research regarding inpatient suicide is a critical need.