Opening the black box of registration practice for self-harm and suicide attempts in emergency departments: a qualitative study

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Sarah Grube Jakobsen, Pernille Tanggaard Andersen, Jens Lauritsen, Christina Petrea Larsen, Elsebeth Stenager, Erik Christiansen
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Abstract

The World Health Organization has called for improved surveillance of self-harm and suicide attempts worldwide to benefit suicide prevention programs. International comparisons of registrations are lacking, however, and there is a need for systematically collected, high-quality data across countries. The current study investigated healthcare professionals’ perceptions of registration practices and their suggestions for ensuring high-quality registration of self-harm and suicide attempts. Qualitative interviews (N = 20) were conducted among medical secretaries, medical doctors, nurses, and registration advisers from psychiatric and somatic emergency departments in all regions of Denmark between September 2022 and March 2023. Content analysis was performed using NVivo. Despite great efforts to standardize and assure the quality of registration in Denmark, almost all the healthcare professionals perceived registration practice as inconsistent and unreliable. Codes are often misclassified or unused due to insufficient time, non-standardized training, or insufficient information. The interview informants suggested that coding guidelines should be simplified and made more visible, alongside technical solutions in the electronic health record system. The study findings resulted in eight overall recommendations for clinical practice that aim at improving the registration of patients presenting with self-harm or suicide attempts. This would be expected to help improve surveillance and prevention programs.
打开急诊科自我伤害和自杀未遂登记实践的黑匣子:一项定性研究
世界卫生组织呼吁在全球范围内加强对自残和自杀未遂行为的监测,以利于自杀预防计划的实施。然而,目前还缺乏对登记情况的国际比较,因此需要系统地收集各国的高质量数据。本研究调查了医护人员对登记实践的看法,以及他们对确保自残和自杀未遂登记高质量的建议。在 2022 年 9 月至 2023 年 3 月期间,对丹麦所有地区的精神科和躯体急诊科的医疗秘书、医生、护士和登记顾问进行了定性访谈(N = 20)。使用 NVivo 进行了内容分析。尽管丹麦在注册标准化和质量保证方面做出了巨大努力,但几乎所有医护人员都认为注册实践不一致、不可靠。由于时间不够、培训不规范或信息不足,编码经常被错误分类或未被使用。受访者建议,应简化编码指南并使其更加清晰可见,同时在电子健康记录系统中采用技术解决方案。研究结果为临床实践提出了八项总体建议,旨在改进对自我伤害或自杀未遂患者的登记工作。预计这将有助于改善监控和预防计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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