Self Harm Questions in Triage

[KNARE]

Joint Commission visited a few wks ago. We have an electronic chart and the "Self Harm" questions are on approx. 20 Chief Complaints -- (Overdose, Depression, ETOH intox, Altered Mental Status, etc. etc.) JC advised us that each pt. who presents to the ED needs to be asked these questions. The exception would be age 3 and under as they do not have the ability to have intent. Do you ask all your pts. the self harm questions? If so, how do you "script" them? Espec. for pts. with minor complaints / problems. Any help, info would be greatly appreciated!!!!

Thank you!!!

[Altra, BSN, RN]

Are you saying that it was suggested that the self-harm assessment be completed on every patient in triage?

Sure ... let's delay that chest pain patient while we ask if they have any thoughts about harming him/herself. :icon_roll :stone

[justme1972]

Are you saying that it was suggested that the self-harm assessment be completed on every patient in triage?

Sure ... let's delay that chest pain patient while we ask if they have any thoughts about harming him/herself. :icon_roll :stone

Heck yeah!

That MI patient with crushing angina or the lady with the large kidney stone....I'm sure when asked, "Have you ever thought about harming yourself or others."

You'll get 100% on those.

They'll say, "Sure, I'm about to take out every person in this entire ER if someone doesn't stop asking me stupid questions and get me some help!"

...nothing against you OP...:) Just another JC rep not thinking things through.

[June55Baby]

KNARE, check with your hospital's Joint Commission coordinator... from what I understand according to The Joint Commission, that requirement is "...applicable to psychiatric hospitals and patients being treated for emotional or behavioral disorders in general hospitals."

Since we are a general hospital, we only assess patients who enter our ER with behavioral disorder as "Chief Complaint".

The patient may suffer from anxiety, but if the reason they came to our ER was because they were in an MVC, anxiety would not be their "Chief Complaint".

If they come in saying they are depressed and anxious, yes an assessment is indicated.

[mmutk, BSN, RN, EMT-I]

Not only do we ask each patient over 17 years old of they feel like they are going to harm themselves, but also we ask anyone over 17 if they feel safe at home (domestic violence).

Every patient, every time no matter what. Thanks to Joint Commission.

[ernurse1993]

We not only have to ask them about suicidal/homicidal thoughts, and if they feel safe in there home's. But if they have access to enough food, if they need any assistance at home, and if they live with anyone!! I think JC needs to walk in our shoes for a 12 hour shift and ask over 200 people those questions every day!! We have removed a lot of the questions out of the triage portion of our documentation, but it has to be completed in our assessments!

[Salls25]

We were visitied recently also, what came of it was that we don't 'assess' everyone for self harm, but do a quick 'screen' on EVERY patient. adds a lot to triage including who do you live with, does anyone hurt you.

[Knoodsen]

Remember what AIDS did for us. We treat everybody as if they have a horrible disease. That's so we avoid offending a few people, possibly. Here it comes. We are now going to treat everyone like they are suicidal victims of domestic abuse. The nanny state marches on. Makes me homicidal (almost). (I put that last in for the moderators. They seem incapable of recognizing humor.)