Nurses' knowledge of the italian ministerial recommendation no. 4 (MR4) on the prevention of patient suicide in hospitals: a pilot study

Maurizio Calamita; Donatella D'Accolti; Carmela Marseglia; Carmela Fiore; Stefania Crescenza Pietanza; Salvatore Grasso; Livio Melpignano; Antonio Pisciotta; Laura Pagliari; Noemi Chiumarolo; Vito Muschitiello

doi:10.54103/dn/27603

Autori/Autrici

Maurizio Calamita AOUC Policlinico - John XXIII Children's Hospital, Bari, Italy https://orcid.org/0009-0001-3064-7396
Donatella D'Accolti AOUC Policlinico di Bari, Bari, Italy
Carmela Marseglia AOUC Policlinico, Bari, Italy
Carmela Fiore ASL Foggia - Distretto Socio Sanitario n.54, Manfredonia (FG)
Stefania Crescenza Pietanza ASL Bari - Ospedale "Di Venere" - Carbonara di Bari (BA)
Salvatore Grasso AOUC Policlinico di Bari, Bari, Italy
Livio Melpignano AOUC Policlinico - Ospedale Pediatrico Giovanni XXIII, Bari (BA)
Antonio Pisciotta AOUC Policlinico - Ospedale Pediatrico Giovanni XXIII, Bari (BA)
Laura Pagliari AOUC Policlinico - Ospedale Pediatrico Giovanni XXIII, Bari (BA)
Noemi Chiumarolo Studente, Università di Bari "Aldo Moro", Bari (BA)
Vito Muschitiello Azienda Ospedaliera Universitaria Consorziale Policlinico Bari https://orcid.org/0009-0008-4592-6778

DOI:

https://doi.org/10.54103/dn/27603

Parole chiave:

Suicidio, Prevenzione, Infermiere, Conoscenza, Ospedale

Abstract

BACKGROUND: le aziende sanitarie sono responsabili della prevenzione del suicidio di paziente in ospedale attraverso l’elaborazione di protocolli che recepiscano la Raccomandazione Ministeriale n.4 (RM4) del Ministero della Salute, 2008. In Italia non ci sono scale di valutazione che indagano il livello di conoscenza della RM4. Obiettivi: Valutare il livello di conoscenza della RM4 da parte degli infermieri.

METODI: studio pilota condotto nel periodo tra Novembre 2023 e Dicembre 2023 in un campione di infermieri. Il questionario somministrato consisteva in 8 domande che indagavano il livello di conoscenza della RM4.

RISULTATI: 141 infermieri eleggibili hanno partecipato al questionario (90.4%). Di questi il 36.9% avevano età anagrafica tra i 30 e 40 anni e 48 intervistati avevano esperienza lavorativa minore di 10 anni. L’alpha di Cronbach della scala era 0,486. Il 62.4% del campione aveva un buon livello di conoscenza della RM4. Il rischio di non conoscere la RM4 è risultato significativamente alto per i soggetti con età superiore a 50 anni (RR=1.86; IC=1.04 – 3.34; p =.034); analogamente, il rischio di non conoscere la RM4 è risultato abbastanza alto per i soggetti con più di 30 anni di servizio (RR=1.80; IC=0.89 – 3.65; p =.101).

CONCLUSIONI: nonostante lo strumento necessiterebbe di una revisione più approfondita per una maggiore affidabilità, il livello di conoscenza della RM4 è risultato ottimale; le criticità emerse riguardano gli infermieri con età ed esperienza lavorativa avanzate. E' urgente sperimentare strategie formative per la prevenzione del suicidio di paziente in ospedale.

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Riferimenti bibliografici

1. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet, 2016; 388:1459.

2. Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS). Leading Causes of Death Reports 1981 - 2016. Atlanta, GA. U.S department of Health and Human Services. 2017

3. Istituto Superiore di Sanità. WHO, suicides: the size of the problem. Epicenter-Epidemiology for Public Health. Available from: https://www.epicentro.iss.it/mentale/schedasuicidi (visited 16/12/2024)

4. Vichi M, Ghirini S, Pompili M, Erbuto D, Siliquini R. Suicide. In the 2018 Osservasalute Report: state of health and quality of care in the Italian regions. Milan: Prex S.p.a. 2019.

5. Vichi M, Vitiello B, Ghirini S, Pompili M. Does population density moderate suicide risk? An Italian population study over the last 30 years. European Psychiatry. 2020.Volume 63, Issue 1.

6. National Observatory for the Monitoring of Sentinel Events. Sentinel Event Monitoring Protocol 6th Report (January 2005 - December 2020). Directorate-General for Health Planning Office 3 - Quality, Clinical Risk and Hospital Planning. Ministry of Health. 2021.

7. Clinical Governance - Patient Safety. Prevention of patient suicide in hospital. Department of Quality General Directorate of Health Planning, Levels of Care and System Ethical Principles Office III. Ministry of Health. 2008.

8. Pesce A, Attanasio C. Suicide risk management in the National Health Service: from clinical-organizational limits to eHealth perspectives. L’infermiere. 2023. Volume 1.

9. Italy. Law no. 24 of 8 March 2017. Provisions on the safety of care and of the assisted person, as well as on the professional liability of health professionals. Official Gazette – General Series no. 64, 17 March 2017.

10. Clua-García R, Casanova-Garrigós G, Moreno-Poyato AR. Suicide care from the nursing perspective: A meta-synthesis of qualitative studies. J Adv Nurs. 2021. 77(7):2995-3007.

11. Zalsman G, Hawton K, Wasserman D, Van Heeringen K, Arensman E, Sarchiapone M, Carli V, Höschl C, Barzilay R, Balázs J, Purebl G, Kahn JP, Sáiz PA, Lipsicas CB, Bobes J, Cozman D, Hegerl U, Zohar J. Suicide prevention strategies revisited: 10-year systematic review. The Lancet Psychiatry. 2016. 3(7), P646-659.

12. Patra KP, De Jesus O. Sentinel event. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2024.

13. Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, Lancaster GA; on behalf of the PAFS consensus group. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. Pilot and Feasibility Studies. 2016. 2:64.

14. Costello AB, Osborne JW. Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment Research & Evaluation. 2005. 10(7).

15. Kline RB. Principles and practice of structural equation modeling. 3rd ed. New York: Guilford Publications. 2011.

16. Costello AB, Osborne JW. Exploring best practices in Factor Analysis: Four mistakes applied researchers make. Paper presented at the Paper presented at the annual meeting of the American Educational Research Association, Chicago, Ill, April. 2003.

17. Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011. 2:53–55.

18. Zatzick D, Jurkovich GJ, Rivara FP, Wang J, Fan MY, Joesch J, Mackenzie E. A national US study of posttraumatic stress disorder, depression, and work and functional outcomes after hospitalization for traumatic injury. Ann Surg. 2008. 248(3):429-437.

19. Mills J, Birks M, Francis K, Miles M, Jones J. Australian rural remote registered nurses' experiences of learning to provide antenatal services in general practice: A pilot study. International Journal of Nursing Practice. 2010. 16: 319–325.

20. Cutcliffe JR, Stevenson C. Feeling our way in the dark: the psychiatric nursing care of suicidal people--a literature review. Int J Nurs Stud. 2008. 45(6):942-53.

21. Ouzouni C, Nakakis K. Nurses' attitudes towards attempted suicide. Health Science Journal. 2013. 7(1):119-134.

22. Lygnugaryte-Griksiene A, Leskauskas D, Jasinskas N, Masiukiene A. Factors influencing the suicide intervention skills of emergency medical services providers. Med Educ Online. 2017. 22(1):1291869.

23. Rebair A, Hulatt I. Identifying nurses' needs in relation to suicide awareness and prevention. Nurs Stand. 2017. 31(27):44-51.

24. Huang KC, Jeang SR, Hsieh HL, Chen JW, Yi CH, Chiang YC, Wu HP. Survey of knowledge, self-efficacy, and attitudes toward suicide prevention among nursing staff. BMC Med Educ. 2023. 23(1):692.

25. Gask L, Dixon C, Morriss R, Appleby L, Green G. Evaluating STORM skills training for managing people at risk of suicide. J Adv Nurs. 2006. 54(6):739-50.

26. Oordt MS, Jobes DA, Fonseca VP, Schmidt SM. Training Mental Health Professionals to Assess and Manage Suicidal Behavior: Can Provider Confidence and Practice Behaviors be Altered. 2011. Volume39, Issue1; pp. 21-32.

27. Ramberg IG, Wassermann D. Suicide-preventive activities in psychiatric care: evaluation of an educational programme in suicide prevention. Nord J Psychiatry. 2004. 58(5):389-94.

28. Chan SW, Chien W, Tso S. Evaluating nurses’ knowledge, attitude and competency after an education programme on suicide prevention. Nurse Education Today. 2009. Volume 29, Issue 7, pp.763-769.

29. Giacchero Vedana KG, Magrini DF, Zanetti ACG, Miasso AI, Borges TL, DosSantos MA. Attitudes towards suicidal behaviour and associated factors among nursing professionals: a quantitative study. J Psychiatr Ment Health Nurs. 2017. 24(9–10):651–9.

30. Blair EW, Chhabra J, Belonick C, Tackett M. Non-psychiatric nurses’ perceived self-efficacy after an educational intervention on suicide prevention and care. J Psychosoc Nurs Ment Health Serv. 2018. 56(6):43–51.

31. Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: The Scale of Suicide Ideation. Journal of Consulting and Clinical Psychology. 1979. 47 (2):343-52.

32. Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin GA, Greenhill L, Shen S, Mann JJ. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011. 168(12):1266-77.

33. Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, Nikanfar AR. Design and Implementation Content Validity Study: Development of an instrument for measuring Patient-Centered Communication. J Caring Sci. 2015 Jun 1;4(2):165-78. doi: 10.15171/jcs.2015.017. PMID: 26161370; PMCID: PMC4484991.

34. Ferracuti S, Barchielli B, Napoli C, Fineschi V, Mandarelli G. Evaluation of official procedures for suicide prevention in hospital from a forensic psychiatric and a risk management perspective. Int J Psychiatry Clin Pract. 2020. 24(3):245-249.