Date of Conferral
10-21-2025
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Cheryl Holly
Abstract
Suicide remains a critical public health issue in the United States, with rates continuing to rise despite national prevention initiatives. Primary care settings serve as a pivotal point for early detection, yet inconsistent use of standardized screening and safety planning tools contributes to under-recognition of suicide risk. This Doctor of Nursing Practice (DNP) project aimed to enhance the identification and management of suicide risk in primary care by developing and implementing an evidence-based clinical practice guideline (CPG). The project addressed the practice-focused question: Does implementing a standardized suicide prevention guideline using validated tools improve risk detection and management in primary care? The CPG was developed in accordance with current national recommendations from the American Psychiatric Association (2023), the Substance Abuse and Mental Health Services Administration (2020), and The Joint Commission (2024). It incorporated validated tools, including the Patient Health Questionnaire-9 (PHQ-9), Columbia-Suicide Severity Rating Scale (C-SSRS), and Safety Planning Intervention (SPI). An expert panel of five clinicians evaluated the guideline using the AGREE II instrument (Brouwers et al., 2017), yielding a high overall mean score of 6.5/7, indicating strong methodological rigor, clarity, and applicability. Implementation took place in a primary care practice, involving staff education, EMR integration, and workflow modifications. Post-implementation chart audits (n = 50) demonstrated an 83% compliance rate with suicide screening and documentation protocols, reflecting strong early adoption. Noncompliance was primarily due to incomplete documentation rather than omission of screening. Thematic feedback from providers highlighted improvements in confidence, usability, and feasibility of integration, although time constraints and workflow adjustments were noted as barriers. Findings indicated improved detection, documentation, and management of suicide risk, as well as enhanced provider awareness and adherence to evidence-based practices. The project supports organizational goals related to patient safety, quality improvement, and mental health equity. By embedding standardized suicide prevention protocols into routine care, this initiative promotes sustainability, fosters culturally competent practice, and advances social change by reducing stigma and preventable deaths. Continued evaluation, periodic training, and ongoing chart audits are recommended to ensure long-term sustainability and impact. Keywords: suicide prevention, primary care, clinical practice guideline, AGREE II, PHQ-9, C-SSRS, safety planning
Recommended Citation
Volcy, Syndie, "Improving Suicide Risk Detection and Management in Primary Care" (2025). Walden Dissertations and Doctoral Studies. 18508.
https://scholarworks.waldenu.edu/dissertations/18508
