Suicide and Depression Screening in the Emergency Department Essay Example

emotional disorders (King, Berona, Czyz, Horwitz, & Gipson, 2015).

How does the Clinical problem impact on nursing?

For a fact, nurses working in emergency departments and psychiatric wards are prone to hand on interaction with depressed patients or even encounter suicide in their working environment. In most cases, these nurses are affected by post-suicide or depression stress that affects their performance and social lives (Betz, Arias, Miller, Barber, Espinola, Sullivan, Manton, Boudreaux, 2015). According to Chang and Tan 2015, more than 75% of nurses working in the emergency department have experienced a suicidal case.

Therefore, screening for suicidal thoughts and depression in the emergency department may lead to increase of post-trauma stress disorder among the nurses and health care givers. In simpler terms, the clinical problem brings in mental distress to the nursing working environment.

Describe the impact of technology on the clinical problem

In the current age of modernity, technological innovations in the health sector are playing a significant role in assisting the screening of depression and suicide in the emergency departments. One of the most successful technologies in use is the Electronic Health Records (EHRs). Electronic Health Records are playing a vital role in screening and assessment of depression and suicidal thoughts (Chang & Tan, 2015).

Electronic Health Records are easily programmed to prompt depression and suicide risk screening. Also, this technology provides guidance and support for further risk assessment while facilitating other clinical interventions such as outpatient discharge decisions capped with suicide prevention resources. Moreover, electronic health records can be designed and set to pre-screen and inform health providers (within the emergency department) when high-risk patients are seen with the documented signs and symptoms

of a previous history of suicidal attempts or psychiatric disorder. Therefore, from this exploration, it is evident that technology has been assisting the emergency department in pre-screening, actual screening and assessment of affected patients as well as facilitating the discharge process. Evaluate the research evidence in terms of validity and reliability of the data.

Did the studies use the proper Statistical tests?

Yes, most of the studies applied statistical calculation of “mean” to test the age group at risk.

According to the results, 90% of youths are at a higher chance of acquiring help from the emergency departments due to depression and suicidal thoughts. Furthermore, ANOVA, logical regression and t-tests were used in testing the relation between one variable to the health concerns within the clinical problem. For example, exposure to suicidal cases was used as a dependent variable that increased the chances of mental distress and post-traumatic stress disorders among the nurses (Betz, Arias, Miller, Barber, Espinola, Sullivan, Manton, Boudreaux, 2015). Additionally, the same statistical tests were used in assessing and confirming the risk factors that can result in an individual being a visitor of the Emergency Department for depression and suicidal cases. The sample sizes were also very appropriate.

The researchers used a cutting across descriptive research design that picked individuals from all age groups in an urban setting. The actual sample size was ten people from youths and ten from the adults who made the sample size of 20 participants. Data from the participants were collected through used of interviews and open-ended questionnaires. The advantage of these open-ended questionnaires is that they gave the research a better platform to evaluate their participant’s mental condition.

Collected data was analyzed using SPSS as a way of getting the actual means and correlation between the research variables.

What are the potential risks to human subjects in the studies?

Human subjects in the studies may be exposed to three types of potential risks.

These are; Social, Psychological, and physical risks. The physical risks may be as a result of exposure to minor discomfort, invasive medical procedures or reduced pain from the screening procedures. Psychological risks may as results of forced or undesired changes in individual emotions and thinking process while screening depression, stress or suicidal thoughts. The social risks are closely related to invasion of individual privacy and confidentiality which may eventually destroy their social relations (Chang & Tan, 2015).

What methods did the researchers' employ to protect human studies?

The researchers in our case used sufficient expertise and experienced medical assessors while evaluating the participants in order to ensure reduced on no physical pain or harm. To test for depression and mental disorders, the researchers used standard-of-care procedures that ensured no physical or psychological harm was directed to the sample size (Betz, Arias, Miller, Barber, Espinola, Sullivan, Manton, Boudreaux, 2015).

Lastly, they obtained voluntary informed consent from the participants supplemented by a confidentiality note that worked in protecting the participant’s information from spilling to the outer world. In so doing, the methods ensured that the activities were more beneficial than harmful to the involved individuals (Chang ; Tan, 2015).

Do you feel that the study participants had adequate protections? Why?

Yes, in most studies, the researchers collaborated with hospitals, psychologists as well as therapists to ensure a smooth collection of information. Furthermore, they applied

the ethical consideration pillars that made sure that the consent, safety, and confidentiality of collected information.

What are the strengths or limitations of the research articles?

Before focusing on the strengths and limitations, it is important noting that the articles considered in this case used both the qualitative and quantitive research methods.

The quantitive research offered population size, demographics, age, emergency department preferences and statistical data for the previous and current population at risk which was paramount to our study. On the other hand, the qualitative research article provided the population information such as risk factors, medical history, behavior patterns, needs, and preferences. One major strength of these articles is that the data and information provided was very precise, reliable and consistent to our study topic. Also, they provided a detailed account of the experiences at the Emergency Department which made it easy for the readers to understand the effects of the clinical problems to both the patients and the nurses.

Despite the strengths, lack of file source for some of the data placed in the articles stood as one primary limitation to the research articles.

What are the trends or patterns that you noticed?

From the articles, it is evident that most nurses in the Emergency Department have been diagnosed with mental distress following their exposure to suicidal cases. The core reason for this trend is lack of health-care programs that assess and care for the needs of the nursing serving in these emergency and psychiatric departments (Betz, Arias, Miller, Barber, Espinola, Sullivan, Manton, Boudreaux, 2015). Following this, a good number of nurses are suffering from post-traumatic stress disorders which are workplace influenced. Another common trend

is that Emergency Departments for suicide and depression screening are receiving more youths as compared to adults.

According to the American Psychologists Association, an increase in drug and substance abuse, isolation from social groupings and poor parenting styles are some of the factors influencing an increase in the number of youths diagnosed with depression and suicidal thoughts (King, Berona, Czyz, Horwitz, ; Gipson, 2015). Finally, the health care system has begun appreciating technology in screening and assessing depression and suicidality among our population. Clinicians and nurses within the Emergency Department are applying standardized and technologically validated screeners such as Electronic Health records to detect and suggest an actionable solution to the affected patients. This has made it easy for health care providers to screen and treat people who are believed to being an imminent risk of depression or suicide (Chang ; Tan, 2015).

What are the implications for practice?

From the articles, it is clear the psychiatric-related diagnoses (depression and suicidal thoughts) are heading in the number of patients who visit the Emergency Department. Therefore, screening for depression and suicidality in the Emergency Departments is one successful strategy to lowering the number of suicides happening in our society and reduce risk among the patients.

Furthermore, screening at the Emergency department is very crucial as it acts as an identification of mental disorders and illness center as well as a referral location for immediate medical attention and treatment (Chang ; Tan, 2015). According to the Society for Academic Emergency Medicine Public Health and Education Task Force, more than 30% of older patients visiting a health care Center may be depressed. But, the inability to efficiently detect the depression

escalated to suicidal or self-harm thoughts. Therefore, the screening conducted at Emergency Departments moves in to bridge the gap between the impossible detection of depression to possible detection and assessment of the patient mental well-being (Stockbridge, Wilson, Paga?n ; Choo, 2014). Having this in mind, depression and suicide screening in the Emergency Department is one critical move to lowering the number of suicidality and mental disorders affecting our people.

References

1. Bolton, J. M. (February 01, 2015). Suicide Risk Assessment in the Emergency Department: Out of the Darkness. Depression and Anxiety, 32, 2, 73-75.
2. King, C.

   A., Berona, J., Czyz, E., Horwitz, A. G., ; Gipson, P. Y. (January 01, 2015).

   Identifying adolescents at highly elevated risk for suicidal behavior in the emergency department. Journal of Child and Adolescent Psychopharmacology, 25, 2, 100-8.

3. Chang, B. P., ; Tan, T. M. (January 01, 2015). Suicide screening tools and their association with near-term adverse events in the ED.

   The American Journal of Emergency Medicine, 33, 11, 1680-3.

4. Betz, M. E., Arias, S. A., Miller, M., Barber, C., Espinola, J. A., Sullivan, A. F., Manton, A. P.

   Boudreaux, E. D. (January 01, 2015). Change in emergency department providers' beliefs and practices after use of new protocols for suicidal patients. Psychiatric Services (Washington, D.C.), 66, 6, 625-31.

5. Stockbridge, E. L., Wilson, F.

   A., Paga?n, J. A., & Choo, E. K. (May 01, 2014).

   Psychological Distress and Emergency Department Utilization in the United States: Evidence from the Medical Expenditure Panel Survey. Academic Emergency Medicine, 21, 5, 510-519.

6. Chakravarthy, B., Toohey, S., Rezaimehr, Y., Anderson, C. L., Hoonpongsimanont, W., Menchine, M., & Lotfipour, S. (May 01, 2014). National differences between ED and ambulatory visits for suicidal ideation
   

and attempts and depression. American Journal of Emergency Medicine, 32, 5, 443-447.