Mental health nurses’ experiences of risk assessment of patient self harm in a
Psychiatric Intensive Care Unit.
Abstract
The ongoing high rates of deliberate self harm in Ireland reflect the high level of
psychological and psychiatric morbidity in the population. Mental health nurses work
with people who self harm in many varied settings. Mental health nurses conduct risk
assessments with patients on a daily basis. Although studies have explored the work
and experiences of these nurses, there is a dearth of research which has explored the
experiences of mental health nurses conducting risk assessments with patients who
self harm in Psychiatric Intensive Care Units (PICU).
This study endeavoured to gain an understanding of mental health nurses` experiences
of risk assessment of patients who self harm psychiatric intensive care unit. A
qualitative descriptive approach was undertaken. The sample consisted of seven
registered nurses from a PICU in one Health Service Executive (HSE). Data was
collected using semi – structured interviews and analysed using content analysis.
Analysis of the data identified mental health nurse’s varied awareness and nursing
practices when conducting risk assessments with patients who self harm. Four themes
emerged: nurses’ understanding of self harm behaviour, nurses’ understanding of risk
assessment, risk assessment nursing practices and the role of education for nurses
conducting risk assessments with people who engage in self harm behaviour.
It is recommended that there is a need to examine policies and develop guidelines for
working with people who self harm. This research illustrates that there is a need to
develop risk assessment guidelines appropriate to local service user needs. The
effectiveness of risk assessment approaches for working with people who self harm
needs to be evaluated. In service training is needed to inform nurses of evidence based
structured risk assessment practices for working with people who self harm.
Helena O Connor
Helena.OConnor1@hse.ie
Submitted for partial fulfillment of MSc Nursing
University College Cork
2008.