Increasing Suicide Risk Management Comfort for Sexual Assault Nurse Examiners in Training

Abstract

Purpose: The purpose of this quality improvement (QI) project was to address a gap in education on suicide risk management during sexual assault nurse examiner (SANE) training at the University of Arizona, Tucson. The goal of this project was to develop and deliver an educational intervention to better prepare future SANEs for suicide risk management.Background: Following sexual assault, risk for suicidal ideation and behavior is elevated among patients. It is critical that SANEs are prepared to assess for suicidality and follow through with appropriate suicide risk management, especially in potentially high-risk populations and in individuals who are newly experiencing suicidal ideation. Suicide risk management can be hampered by psychosocial barriers such as the nurse’s emotions, beliefs, knowledge, or attitudes. Studies point to “comfort” working with suicidal individuals as positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices. Educational training, namely QPR (Question, Persuade, Refer) gatekeeper training, has been shown as an effective strategy for providing favorable outcomes in suicide screening and risk management. Methods: This DNP project used one-group pretest-posttest survey design. Recruitment of participants for this project was through convenience sampling. The intervention applied was a 20-minute video educational presentation on QPR. Demographic, pretest, posttest, and feedback surveys were collected during project implementation. Data analysis was conducted using paired t-tests to detect significance between the pre-intervention and post-intervention levels of comfort as measured by a modified and internally validated evaluation tool. Results: A total of 11 participants received an educational intervention and participated in data collection surveys. The total years of experience working as an registered nurse or health care worker ranged from 4 – 23 years (SD = 6.9; Median = 10.8). Data analysis showed a mean pretest score of 19 and mean posttest score of 16.73. The paired t-test revealed that a one-tailed p-value = 0.0479, indicating that the difference between mean scores was statistically significant. Conclusions: The findings of this project support that an educational education creates a statistically significant increase in mean comfort levels in our participants as measured by our evaluation instrument.