Implementing and sustaining evidence-based practices in long-term care.

Suicidal Ideation and Behaviour

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    Increase your comfort, confidence and competence in this practice area, in order to enhance safety for your clients and to lower the impact of suicide to society. The goal of this best practice guideline is to provide nurses with recommendations, based on the best available evidence, related to the assessment and care of adults at risk for suicidal ideation and behaviour.

    Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour

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    Organizational assessment tool to assist with implementation and evaluation of the RNAO Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour BPG by comparing current practice to evidence-based practice. Source: Registered Nurses' Association of Ontario's Long-Term Care Best Practices Program, Toronto, ON, Canada. January 2009.

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    Website that deals with suicide survivors, suicide grief, support for those living with suicide loss along with providing education materials and access to various support and crisis centers . it also addresses suicide risk in the aging population. Its main purpose is to reduce suicide rate in Canada and minimize the consequences of suicide behaviour.

    Reference: Canadian Association of Suicide prevention (CASP), https://suicideprevention.ca/ 

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    Numerous resources available with a simple search engine within this website

    Reference: Centre for Suicide Prevention [Online] Available: https://www.suicideinfo.ca/resources/ 

    Copyright: The Centre for Suicide Prevention Web Site is offered to you conditioned on your acceptance without modification of the terms, conditions, and notices contained herein. Your use of the Centre for Suicide Prevention Web Site constitutes your agreement to all such terms, conditions, and notices.

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    Centre for Suicide Prevention site contains a large collection of suicide prevention, intervention, and postvention resources, including Plus 65- a resource toolkit specific to seniors.

    Reference: Centre for Suicide Prevention Website: http://www.suicideinfo.ca/

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    Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents’ responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting.

    Reference: O'Riley A, Nadorf MR, Conwell Y, Edelstein B. Challenges associated with managing suicide risk in long-term care facilities. Annals of Long-Term Care: Clinical Care and Aging. 2013;21(6):28-34. http://www.managedhealthcareconnect.com/article/challenges-associated-managing-suicide-risk-long-term-care-facilities 

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    Numerous resources available with a simple search engine. Updates noted for 2017.

    Reference: Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Deliberate Self-harm. 2016, Australian and New Zealand Journal of Psychiatry 2016, Vol 50(10) 939-1000. https://www.ranzcp.org/Files/Resources/Publications/CPG/Deliberate-self-harm-CPG.aspx  

    The Centre for Suicide Prevention Web Site is offered to you conditioned on your acceptance without modification of the terms, conditions, and notices contained herein. Your use of the Centre for Suicide Prevention Web Site constitutes your agreement to all such terms, conditions, and notices.

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    The Decision Making Framework provides an ethical approach for choosing care strategies following the observation of a deliberate act.

    Retrieved from http://ccethics.com/ethics-service/decision-making-framework/ 

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    This is a “Sentinel Event Action Alert” , a complimentary publication of The Joint Commission Issue 56, February 24, 2016 “Detecting and treating suicide ideation in all settings” Through this alert, The Joint Commission aims to assist all health care organizations providing both inpatient and outpatient care to better identify and treat individuals with suicide ideation

    Reference: Joint Commission on Accreditation of Healthcare Organizations (JCAHO). (2016). Detecting and treating suicide ideation in all settings. [Online]. Available: https://www.jointcommission.org/assets/1/18/SEA_56_Suicide.pdf  

    Copyright © 2017 The Joint Commission, One Renaissance Boulevard, Oakbrook Terrace, IL 60181

    All materials posted on this site are subject to copyrights owned by The Joint Commission. The Joint Commission hereby provides limited permission to the user (you) of this site to reproduce, retransmit, or reprint for such user's own personal use part or all of any document on this site as long as the copyright notice and permission notice contained in such document or portion thereof is included in such reproduction, retransmission, or reprinting. All other reproduction, retransmission, or reprinting of all or part of any document found on this site is expressly prohibited, unless The Joint Commission has expressly granted its prior written consent. All other rights reserved. See Permissions/Reprints Policy.

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    A List of educational resources compiled by the development panel as a resource for nurses and their clients in learning more about suicidal ideation and behaviour. This is not intended to be an inclusive listing.

    Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour 

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    Une pratique efficace des soins infirmiers dépend d’une relation thérapeutique efficace entre le client et l’infirmière. Cette Ligne directrice porte sur les qualités d’une relation thérapeutique efficace, sur les possibilités qu’elle offre, sur l’état des connaissances et sur les connaissances requises afin de pouvoir travailler efficacement dans une relation thérapeutique. Afin qu’une relation thérapeutique puisse être instaurée avec succès, les valeurs du milieu de travail et les caractéristiques essentielles de l’établissement doivent être en place et doivent être compatibles avec cet objectif. Une feuille de travail sur le niveau de préparation de votre établissement est compris.

    Association des infirmières et infirmiers autorisés de l’Ontario (2006). Établissement de la relation thérapeutique. Toronto, Canada : Association des infirmières et infirmiers autorisés de l’Ontario. http://rnao.ca/bpg/guidelines/establishing-therapeutic-relationships

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    An RNAO resource page 109 – 112, Appendix P with strategies to collect information, identify the problem, explore alternatives to identify solutions

    Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour 

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    A complete toolkit for educational purposes. Composed in 2008 and content uploaded in 2016. Key elements of the CCSMH Late Life Suicide Prevention Toolkit include: • DVD - Suicide Assessment & Prevention for Older Adults: Life Saving Tools for Health Care Providers • CCSMH National Guidelines for Seniors’ Mental Health: The Assessment of Suicide Risk and Prevention of Suicide • Clinician pocket-card • PowerPoint presentation • Facilitator’s Guide with tips for using the Toolkit in a variety of ways

    Reference: Canadian Coalition for Seniors’ Mental Health (2008) Late Life Suicide Prevention Toolkit, Facilitators Guide. Available at http://ccsmh.ca/wp-content/uploads/2016/03/FacilitatorsGuide.pdf 

    © Canadian Coalition for Seniors’ Mental Health, 2008 In order to meet the educational needs of your learners, some materials in the toolkit may be modified. Please acknowledge that the information was provided by the Canadian Coalition for Seniors’ Mental Health Late Life Suicide Prevention Toolkit.

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    This article published for US library of Medicine article compares depressed in patients with and without CCPD in terms of suicidal behaviour and associated psychopathology.

    Reference: Dervic, Kanita et al. “Cluster C Personality Disorders in Major Depressive Episodes: The Relationship Between Hostility and Suicidal Behavior.” Archives of suicide research : official journal of the International Academy for Suicide Research 11.1 (2007): 83–90. PMC. Web. 22 Dec. 2017. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3779124/ 

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    RNAO resource page 105, Appendix M. Listed interventions as potentially beneficial to providing supportive care in postvention. Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour 

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    This document from Mood Disorders Society of Canada provides helpful information on suicide risk and support strategies.

    Reference: Mood Disorders Society of Canada (n.d.) Risk of Suicide. Retrieved from http://mdsc.ca/documents/Consumer%20and%20Family%20Support/Risk%20of%20suicide.pdf

    © Copyright 2016 Mood Disorders Society of Canada | All Rights Reserved | Powered by Dreamconcepts 

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    Gain an overview of the most compelling evidence about diversity; understanding it, accepting the differences it brings to work settings, and finally, to seeking and embracing diversity.

    This panel has been developing guidelines that recommend a congruent set of work place behaviours, management practices and institutional policies within a practice setting resulting in an organizational environment that is respectful and inclusive of cultural and other forms of diversity.

    Reference: Registered Nurses’ Association of Ontario (2007). Embracing Cultural Diversity in Health Care: Developing Cultural Competence. Toronto, ON: Author. http://rnao.ca/bpg/guidelines/embracing-cultural-diversity-health-care-developing-cultural-competence

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    Effective nursing practice is dependent on an effective therapeutic relationship between the nurse and the client. This guideline addresses the qualities and capacities of an effective therapeutic relationship, the state of knowledge, and the knowledge needed to be effective. To implement a therapeutic relationship successfully, an organization's characteristics and workplace values must be supportive and in place. An organization readiness assessment based on the best practice recommendations is provided. Supplement: 2006

    Registered Nurses’ Association of Ontario. (2002). Establishing therapeutic relationships. Toronto, ON, Canada: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/Establishing_Therapeutic_Relationships.pdf

     

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    Increase your knowledge in promoting family health through interventions and supports provided during expected (i.e. birth, school, adolescence, aging, and death) as well as unexpected (i.e. trauma/accidents, chronic illness, developmental delay and disability) life events. Focusing on the family is an integral component of nursing practice. This guideline was developed to promote and facilitate continuing education, reflection and reaffirmation of the importance of caring for families. Supplement: 2006

    Registered Nurses’ Association of Ontario. (2002). Supporting and Strengthening Families Through Expected and Unexpected Life Events. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/supporting-and-strengthening-families-through-expected-and-unexpected-life-events

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    RNAO resource page 106, Appendix N. Listed potential strategies that offers debriefing for staff involved in the care of a client who has completed suicide.

    Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour 

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    This clinician pocket-card provides suicide information and is based on the Canadian Coalition for Seniors Mental Health national guideline: The Assessment of Suicide Risk and Prevention of Suicide

    Reference: Canadian Coalition for Seniors Mental Health (2000). National Guidelines for Seniors Mental Health- The Assessment of Suicide Risk and Prevention of Suicide Brochure. Retrieved from http://ccsmh.ca/wp-content/uploads/2016/03/CCSMH_suicideBrochure.pdf  

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    This clinician pocket card supports assessment resources for the assessment and prevention of suicide in older adults. The Geriatric Suicide Ideation Scale and the Harmful Behaviours Scale mentioned on the clinician pocket-card can be used by health care providers with appropriate training.

    Reference: Canadian Association of Mental Health (CAMH) Clinician Pocket Care Suicide Assessment and Prevention for Older Adults (2015). Retrieved from http://ccsmh.ca/wp-content/uploads/2016/03/CCSMH_suicideBrochure.pdf 

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    The CAMH Suicide Prevention and Assessment Handbook is a quick, comprehensive and interactive starting point for staff across all clinical programs on the subject of suicide assessment and management. It provides key clinical information, current CAMH tools and resources, and further population-specific resources.

    Reference: Canadian Association of Mental Health (CAMH). (2015). Retrieved from https://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/suicide/Documents/sp_handbook_final_feb_2011.pdf 

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    Website full of resources with a great search engine pertaining to suicide and the elderly.

    Reference: Centers for Disease Control and Prevention (CDC) [Online] Available: https://www.cdc.gov/ViolencePrevention/suicide/ 

    Copyright: Information that is created by or for the US government on this site is within the public domain. Public domain information on CDC Stacks may be freely distributed and copied. However, it is requested that in any subsequent use of this work, CDC be given appropriate acknowledgment.

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    A website from Government of Canada about suicide, prevention, risk factors, how to get help. It reviews potential risks, prevention, factors that may increase risk and resources along with overview of federal initiative in suicide prevention.

    Reference: https://www.canada.ca/en/public-health/services/suicide-prevention.html 

    https://www.canada.ca/en/public-health/services/publications/healthy-living/overview-federal-initiatives-suicide-prevention.html 

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    Canadian Coalition for Seniors’ Mental Health, Suicide Assessment & Prevention for Older Adults, Life Saving Tools for Health Care Providers.

    Web Address or Source: http://ccsmh.ca/projects/suicide/  

    © Canadian Coalition for Seniors’ Mental Health, 2008 In order to meet the educational needs of your learners, some materials in the toolkit may be modified. Please acknowledge that the information was provided by the Canadian Coalition for Seniors’ Mental Health Late Life Suicide Prevention Toolkit.

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    Objectives. We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. Conclusions. LTC may be an important point of engagement in suicide prevention.

    Reference: Mezuk, B. Lohman, M. Leslie, M. Powell, V. 2015, July. Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003–2011, Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463392/ 

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    Review struggles commonly faced by many older adults, including the loss of family and friends, debilitating sickness / disease and loss of independence and isolation. Found on the Canadian Association for Suicide Prevention Website (CASP).

    Reference: Suicide risk in the aging population available: https://suicideprevention.ca/suicide-risk-in-the-aging-population/ 

    Copyright All Rights Reserved © 2016.

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    Reviews how to support workplace and colleagues as a result of suicide, along with workplace bullying and strategies to minimize suicide rates.

    Reference: The workplace suicide prevention toolkit: Center for Suicide Prevention, Canadian Mental Health Association; https://www.suicideinfo.ca/wp-content/uploads/2017/05/Workplace-Toolkit.pdf 

    © Center for suicide prevention, All contents of the Centre for Suicide Prevention Web Site are: © Centre for Suicide Prevention and/or its suppliers. All rights reserved.

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    A toolkit from Mental Health Commission of Canada information and access to resources on suicide grief, immediate aftermath, advocacy, information for first nations and capacity building tools.

    Reference: Available online: Toolkit for survivors of suicide loss and Postvention professionals; https://www.mentalhealthcommission.ca/English/initiatives/11889/tool-kit-survivors-suicide-loss-and-postvention-professionals 

    © (2013) Mental Health Commission of Canada. All rights reserved. All materials (including the organization and presentation of such material) on this Web site (the "Materials") are the property of MHCC and its licensors and may be protected by intellectual property laws including laws relating to copyrights, trade-marks, trade-names, internet domain names and other similar rights. Access and use of this Web site is provided by MHCC to accept identified and agree to the listed Terms of Use; such as the information must only be used for lawful purposes, no interference to the website, visit the terms of use periodically as it is updated regularly.

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    This WHO site consists of suicide data, prevention videos and the mhGAP Intervention Guide with a module on self-harm/suicide.

    Reference: Retrieved from http://www.who.int/mental_health/suicide-prevention/en/  

    © Copyright World Health Organization (WHO), 2017. All Rights Reserved.