Care Plan: Behavioral Health

Nursing Diagnosis: Suicidal Behavior

Definition: Risk for Suicide
Defining Characteristics: At risk for self-inflicted, life-threatening injury.
Expected Outcomes: The Patient will:

1. Not harm himself or herself or others.

Intervention:
1. A. Determine the appropriate level of suicide precautions for the client. Institute these precautions
immediately on admission (may be nursing order or by physican order.)
a. Routine checks (q 15 minutes)
b. 5 minute checks
c. Close/continuous observation
d. One to one observation
1. B. Assess the clients suicidal potential, utilizing Suicide/Violence Risk Assessment, and evaluate
the level of suicide precautions at least daily.
1. C In your initial assessment, note any previous suicide attempts and methods, as well as family
history of mental illness or suicide. Obtain this information in a matter-of-fact manner; do not
discuss at length or dwell on details.
1. D. Ask the client if he or she has a plan for suicide. Attempt to ascertain how detailed and
feasible the plan is.
1. E. Explain suicide precautions to the client.
1. F. Be especially alert to sharp objects and potentially dangerous items; items like these should not
be in the clients possession.
1. G. The clients room should be located, preferably near the nurses station.
1. H. Have the client use an electric shaver if possible. Otherwise, observe the patient one on one
while shaving.
1. I. I the client is attempting to harm himself or herself, it may be necessary to restrain the client or
to place him or her in seclusion with how objects that can be used to self-inflict injury.
1. J. Observe, record, and report any changes in the clients mood (elation, withdrawal, sudden
resignation).

Expected Outcomes:
1. Not harm himself or herself or others.
2. Demonstrate use of alternative ways of dealing with stress and emotional problems.
3. Verbalize knowledge of self-destructive behavior(s), other psychiatric problems, and safe use of
medication, if any.
4. Obtain optimal level of comfort.
5. Demonstrate increased level of wellness.
6. Patient/family will demonstrate understanding of condition and barriers to learning.