At the SPINZ National Symposium 2009, the following paper will be presented: Emergency department re-presentations following intentional self-harm by Silke Kuehl and Dr Kathy Nelson.
The abstract is as follows:
A retrospective observational design was selected for a period of one year and data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations.
This study made several discoveries:
many re-presentations (55%) occurred within one day;
the exact number of people who re-presented many times to ED is unknown, but is far higher than reported in other studies;
fewer support people were present for the second presentation;
the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population;
cultural input for Maori was missing;
physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations;
the medical and mental health inpatient admission rates were approximately 40% higher for second presentations.
Recommendations in regard to the use of a triage assessment tool, cultural input for Maori and the need for a mental health consultation liaison nurse in ED will be made. Staff education, collaboration between services with consumer involvement and further research of this group are required.
Further to this, the link above goes to the list of talks to be given at this Symposium. There are a number of culturally-concerned topics, both Maori and Pasifika, as well as some basics regarding suicide prevention. Anyone with a concern for people tending towards suicide should try and make time to attend.
The NZ Tui (in the photo) is used as a kind of logo on the SPINZ site - photo by 'North of Auckland'
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