A Preventive Approach to Inpatient Suicides. A Recommendation for Practice Based On Clinical Data from the Czech Republic

Author(s): Adam Zaludek, David Marx

Background: Inpatient suicide is a severe event that carries a great emotional charge. Not all of suicidal attempts are predictable, but they are often preventable. When there is no precise method of prediction of suicidal behaviour, hospital management has to ensure a safe clinical environment and clinitians have to be able to recognize patient that is at risk of suicide. The aim of this article is to recommend how to reduce the risk of inpatient suicide, according to the recent data from the Czech republic.

Methods: In our study, we have sent questionnaires to acute psychiatric departments in the Czech republic. Questionnaires were designed to cover the area of clinical environment, patient assessment and the use of risk management tools according to the suicide risk reduction.

Results: The study found out that there are problems with the whole process of inpatient suicide prevention. There is no standardised scale of suicide risk assessment in hospitals involved in the study. Psychiatric wards are old and in a bad technical state, so the clinical environment is unsafe. There are also problems in using pro- and retroactive risk management tools, such as failure mode and effect analysis and root cause analysis.

Conclusion: Inpatients suicides are very severe adverse events. According to our study, it is necessary to standardize the way of suicide risk assessment and ensure a safe clinical environment for those patients at the risk of suicide, keeping in mind to balance the necessary restrictions and the dignity of patients.

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