‘SUICIDE RISK TABLE: KEY HIGHLIGHTS from the SUICIDE PREVENTION PLAN Complete all the items in the color-coded column that matches the patient's identified risk. High Risk Moderate Risk DETAILED RISK ASSESSMENT ‘Add the intervention- BH: De- tailed Risk Assessment or add Done by the RN who screened the patient and found the “Suicide” bundle item sees PROVIDER NOTIFICATION Notify the Provider | Notify the Provider of risk level of risk level Document using intervention: Manage/Refer/Contact/Notify PATIENT SAFETY ATTENDANT (PSA) This is a nurse driven process. No order is needed. LINE of SIGHT OBSERVATION Only necessary if thoughts of suicide were in past month and were without method plan/ intent Notify Staffing Office/ House Supervisor or escalate to 11 MAKE ENVIRONMENT SAFE by using the Safe Environment Checklis Document using intervention: Suicide Safe Environment Tip: Add the intervention Repeat every shift, change in primary caregiver, upon transfer to another Unit & as needed with change in patient condition MONITOR & DOCUMENT EVERY 15 MIN -Utilize the Observation Flowsheet (Form 8W-987) which is a permanent part of the medical record. Must include entries by relief person for lunch & breaks REASSESSMENT q shift, Add Intervention: Suicide Reassessment Note: The Safety/Risk/Regulatory sereen is only for inital assessment Reassess the patient every shift and with change in primary caregiver, or transfer to another unit Reassess the patient every shift and with change in primary caregiver, or transfer to another unit HANDOFF Communicate the patient's risk during handoff reports All care giversneed tobe awareof patient's risk All care giversneed ‘to be aware of patient's risk PLAN of CARE Inpatient only) Initiate the Suicide Risk problem. Re-evaluate the plan and keep Re-evaluate the plan and keep updated updated REASSESS RISK PRIOR to If at risk, notify at risk, notify DISCHARGE provider to evaluate | provider to appropriateness of | evaluate (Document notification using Manage/Refer/Contact/Notify) discharge plan appropriateness of discharge plan DISCHARGE (D/C) INSTRUCTIONS Print & give: Patient Discharge Education Suicide Risk Prevention Review with patient, identified support systems, and next level of care, Document DC instructions given Review with patient, identified support systems, and next level of care, Document instructions given