Barriers and Enablers to Pre-Registration Nurses Providing Safe Care for Individuals Experiencing Suicidal Distress: A Scoping Review.

AIMS To identify research gaps by mapping what is known about the barriers and enablers to pre-registration nursing students identifying signs of suicidal distress in healthcare consumers and providing clear pathways of support. DESIGN Scoping review. METHODS This scoping review was conducted using Arksey and O'Malley's (2005) five stage framework and the Levec et al. (2010) extensions of this framework. DATA SOURCES The Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete and Ovid MEDLINE databases were searched to identify relevant articles, keywords and search terms to inform the full search strategy for CINAHL. This search strategy was then adapted for Scopus, PsychInfo, Emcare, Medline and ERIC, searched in November 2024. RESULTS Studies eligible for inclusion (N = 28) represented research from 14 countries; most (53.5%, n = 15) used a quantitative design, 11 (39.3%) were qualitative and two (7.1%) used a mixed-methods design. Barriers found from the scoping review included a low level of knowledge of suicidality, stigma preventing students from assessing and acting on suicidal ideation, and a lack of confidence in providing care to healthcare consumers expressing suicidality. Enablers included lived experience, exposure to individuals expressing suicidal ideation and education, simulation and role play. This review also contributes to the existing literature about the relationship of nursing to existing suicide prevention frameworks and suggests revision of these frameworks to address staff attitudes and beliefs, as well as lived and living experience. CONCLUSION Nurses are ideally placed to assess and respond to suicidality among healthcare consumers, and preparation should begin during pre-registration studies. Our scoping review indicates that further research work is needed to address the barriers to working with healthcare consumers expressing suicidality and to enhance the enablers to provide safe care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Addressing the barriers and enablers to pre-registration nursing students providing safe care for healthcare consumers expressing suicidality is essential. Further research is required to address the barriers and enhance the enablers identified in this scoping review. IMPACT What problem did the study address? This scoping review summarised the literature on pre-registration student ability to work with healthcare consumers expressing suicidality, identifying barriers and enablers. What were the main findings? Barriers include poor knowledge of suicidality, stigma, fear and a lack of confidence in working with healthcare consumers expressing suicidality. Enablers include lived experience, exposure to clinical settings where healthcare consumers express suicidality and simulation and education. Where and on whom will the research have an impact? The research will have an impact on providers of pre-registration nursing degrees, where the inclusion of content addressing suicidality and exposure to settings where individuals express suicidal ideation is shown to improve attitudes and knowledge of suicidality assessment. REPORTING METHOD PRISMA checklist for scoping reviews. PATIENT OR PUBLIC INVOLVEMENT This study did not include patient or public involvement in its design, conduct or reporting.