Suicidality in the Older Adult: A Primary Care Mental Health Simulation

Submitter Information

Author: Craig King Title: Instructor Institution: Case Western Reserve University, Frances Payne Bolton School of Nursing Email: cdk46@case.edu Coauthors: Donna M. Thompson DNP, RN, AGCNS-BC, CCRN, CHSE, CNE; Thomas A. Baum CHSOS, EMT-P

Competency Category(s) Patient-Centered Care, Safety, Teamwork and Collaboration, Interprofessional Partnerships, Person-Centered Care, Quality and Safety

Learning Setting(s): Skills or Simulation Laboratories

Strategy Type: General Strategy

Learning Objectives:

Upon completion of this strategy the learner will:

1.Demonstrate effective use of strategies to reduce harm by utilizing identified mental health risk and protective factors to develop a safety plan for a patient in the primary care setting

2.Demonstrate competent function as a member of the healthcare team by advocating for patient safety to another member of the healthcare team.

3.Assess own level of verbal and non-verbal therapeutic communication skills in an encounter with a patient in the primary care setting

Strategy Overview:

A pair of students will have an encounter with a Standardized Patient in the nursing simulation lab and demonstrate therapeutic communication skills, assess for and differentiate mental health risk and protective factors, and develop a relevant mental health safety plan in collaboration with an advanced practice provider (APRN). It is recommended that students work one on one with the Standardized patient, but they could work in groups of two. Students will be given instructions to perform a nursing mental health assessment, including an assessment of risk and protective factors for suicide. Students will be given 30 minutes to interact with Standardized Patient, review the simulated patient chart and discharge summary. After performing assessment, the student will advocate for patient safety to an individual playing the role of the APRN. Students will be given an opportunity to review their performance after the simulation, either with video recording or direct feedback from observing faculty, depending on capability of the nursing simulation lab.

The Standardized Patient in the simulation will portray a 75-year-old male patient, presenting in the outpatient clinic for his 1-week follow-up appointment after discharge from a hospital stay. This patient will present as medically stable, but with new onset depression and significant risk for suicide. The student will be expected to identify that the patient has a myriad of risk factors, including but not limited to recent loss of spouse, lack of active employment, lack of a natural support system, ready access to a firearm, chronic medical conditions, and lack of future goals.

Attached: Simulated patient chart, Simulated patient discharge summary, background information (for instructor and standardized patient only), student self-reflection document, and completed mental status assessment (for preparation of Standardized Patient.

Submitted Materials:

Deidentified-QSENPsychSimulationSubmission-PDF.pdf-DT-v2.docx

Evaluation Description:

Students will be evaluated on the learning objectives through faculty observation. These observations by faculty will be shared with students immediately following the simulation experience.

Through reflection, the students will evaluate their own performance and the simulation experience.