Emergency Department Safety Assessment and Follow-Up Evaluation (EDSAFE) Trial

急诊科安全评估和后续评估 (EDSAFE) 试验

• 批准号: 8671090
• 负责人: Edwin D Boudreaux
• 金额: $ 16.29万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-06-13 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8671090
• 关键词: Accident and Emergency department; Administrator; Aftercare; Award; Behavior; Caring; Catchment Area; Clinical Research; Counseling; Data; Data Collection; Detection; Effectiveness; Emergency Medicine; Enrollment; Equipment and supply inventories; Evaluation; Evaluation Studies; Experimental Designs; Family member; Feeling suicidal; Funding; Geographic Locations; Health; Health Personnel; Health behavior; Insurance Carriers; Intervention; Lead; Medical; Methods; Modeling; Morbidity - disease rate; National Institute of Mental Health; Nurses; Outcome; Outcome Study; Patients; Performance; Phase; Policy Maker; Premature Mortality; Prevention; Process; Protocols documentation; Quality of Care; Research; Rural; Safety; Sampling; Stratification; Structure; Suicide; Suicide prevention; System; Telephone; Testing; United States National Institutes of Health; Visit; base; behavioral health; clinical practice; demographics; design; evidence based guidelines; falls; flexibility; follow-up; improved; innovation; multi-component intervention; public health relevance; reducing suicide; response; screening; screening and brief intervention; screening, brief intervention, referral, and treatment; suburb; suicidal behavior; suicidal patient; suicidal risk; treatment as usual; treatment planning

DESCRIPTION (provided by applicant): The NIMH?s RFA-Suicide Prevention in Emergency Medicine Departments recognizes the emergency department (ED) as an important setting to increase suicide detection and prevention efforts but observes that evidence-based practice guidelines do not exist. In response, we have designed the ED Safety Assessment and Follow-up Evaluation (EDSAFE) trial. Two inter-related studies will be conducted using a quasi-experimental design appropriate for studying systems-based change. The studies will share three phases of data collection: Treatment as Usual, Screening Alone, and Intervention. During each phase, 472 suicidal patients (1,416 total) will be enrolled and followed using multiple methods for 12 months. The first study, the Screening Outcome Study, will use data collected during the first two phases (Treatment as Usual and Screening Alone). Primarily, it will focus on testing a practical approach to screen ED patients for suicidal ideation and behavior and will assess its impact on suicide detection, process outcomes, and suicide behaviors. The second study, the Care-chain Evaluation Study, will use data collected during the last two phases (Screening Alone and Intervention). Primarily, it will evaluate the impact of a multi-component intervention on suicide outcomes. The intervention blends conceptual underpinnings from screening, brief intervention, and referral to treatment (SBIRT) models for health behaviors with empirically grounded strategies for suicide prevention. It will involve (1) Question, Refer, Persuade counseling provided by the treating nurse, (2) incorporation of a Comprehensive Suicide Management Protocol into clinical practice, and (3) post-discharge telephone counseling. Our overarching hypotheses will be tested using a combination of both studies. We predict that screening will improve detection of suicidal ideation, and the intervention will enhance the quality of care and reduce suicide outcomes. Our studies offer the following innovations and strengths: (1) inclusion of eight general medical EDs representative of broad geographic regions, patient demographics, and catchment areas (i.e., urban, suburban, rural); (2) use of the EMNet, which was awarded a best practice designation by the NIH-funded Inventory and Evaluation of Clinical Research Networks (IECRN); (3) a structured intervention that is empirically based, practical, and flexible enough to accommodate a full spectrum of suicidal ideation and behavior; (4) stratification of the sample and planned analyses to examine whether the intervention?s effectiveness differs based upon baseline suicide risk; (5) a multi-method outcome attainment strategy; and, (6) a multi-component evaluation that will help determine effectiveness, feasibility, and sustainability.

描述(由申请人提供)： NIMH？S-急诊科自杀预防-急诊科(ED)认识到急诊科(ED)是增加自杀检测和预防努力的重要场所，但注意到目前尚不存在循证实践指南。为此，我们设计了ED安全评估和后续评估(EDSAFE)试验。将使用适合于研究基于系统的变化的准实验设计进行两项相互关联的研究。这些研究将分享数据收集的三个阶段：照常治疗、单独筛查和干预。在每个阶段，472名自杀患者(总共1416名)将被登记，并使用多种方法进行为期12个月的跟踪调查。 第一项研究，筛查结果研究，将使用在前两个阶段(照常治疗和单独筛查)收集的数据。它将主要集中于测试一种实用的方法来筛选ED患者的自杀意念和行为，并将评估其对自杀检测、过程结果和自杀行为的影响。第二项研究，医疗链评估研究，将使用在最后两个阶段(单独筛查和干预)收集的数据。首先，它将评估多成分干预对自杀结果的影响。该干预措施将健康行为的筛查、短暂干预和转诊治疗(SBIRT)模型的概念基础与基于经验的自杀预防策略相结合。它将涉及(1)由治疗护士提供的询问、转介和劝说咨询，(2)将综合自杀管理方案纳入临床实践，以及(3)出院后的电话咨询。我们的主要假设将使用两项研究的组合进行测试。我们预测，筛查将提高对自杀意念的检测，干预将提高护理质量，减少自杀结果。 我们的研究提供了以下创新和优势：(1)纳入了代表广泛地理区域、患者人口统计和集聚地区(即城市、郊区和农村)的8个一般医疗急救小组；(2)EMNet的使用，它被美国国立卫生研究院资助的临床研究网络清单和评估(IECRN)授予最佳实践称号；(3)基于经验、实用和灵活的结构化干预措施，足以容纳全方位的自杀意念和行为；(4)样本和计划分析的分层，以检查干预措施是否有效？S的有效性基于基线自杀风险；(5)多方法成果实现战略；和(6)有助于确定有效性、可行性和可持续性的多成分评估。

项目成果

C-SSRS performance in emergency department patients at high risk for suicide.

急诊科患者的C-SSRS表现高自杀风险。

• DOI: 10.1111/sltb.12657
• 发表时间: 2020-12
• 期刊: Suicide & life-threatening behavior
• 影响因子: 3.2
• 作者: Brown LA;Boudreaux ED;Arias SA;Miller IW;May AM;Camargo CA Jr;Bryan CJ;Armey MF
• 通讯作者: Armey MF

Computer Administered Safety Planning for Individuals at Risk for Suicide: Development and Usability Testing.

• DOI: 10.2196/jmir.6816
• 发表时间: 2017-05-15
• 期刊: Journal of medical Internet research
• 影响因子: 7.4
• 作者: Boudreaux, Edwin D;Brown, Gregory K;Miller, Ivan W
• 通讯作者: Miller, Ivan W

Multicenter study of predictors of suicide screening in emergency departments.

急诊科自杀筛查预测因素的多中心研究。

• DOI: 10.1111/j.1553-2712.2011.01272.x
• 发表时间: 2012
• 期刊: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
• 作者: Ting,SarahA;Sullivan,AshleyF;Miller,Ivan;Espinola,JaniceA;Allen,MichaelH;CamargoJr,CarlosA;Boudreaux,EdwinD;EmergencyDepartmentSafetyandFollow-upEvaluation(ED-SAFE)Investigators
• 通讯作者: EmergencyDepartmentSafetyandFollow-upEvaluation(ED-SAFE)Investigators

Executive function and suicidality: A systematic qualitative review.

• DOI: 10.1016/j.cpr.2015.06.005
• 发表时间: 2015-08
• 期刊: CLINICAL PSYCHOLOGY REVIEW
• 影响因子: 12.8
• 作者: Bredemeier, Keith;Miller, Ivan W.
• 通讯作者: Miller, Ivan W.