Date of Conferral

1-29-2026

Date of Award

January 2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Lilo Fink

Abstract

In this doctoral project, I developed a clinical practice guideline (CPG) to address the lack of a standardized suicide risk assessment protocol at a Texas mental health clinic. At project initiation, suicide risk assessment at the facility was inconsistent due to the absence of a CPG. The guideline incorporated the Columbia-Suicide Severity Rating Scale (C-SSRS), a validated instrument that improved early detection of suicidal ideation and behaviors, which were often under recognized in older adults. This inconsistency led to the following clinical question, Does the evidence support the development of a CPG for assessing suicide risk among high-risk patients using the C-SSRS, as measured by a quality score via Appraisal of Guidelines for Research and Evaluation (AGREE) II tool from an expert panel and receives approval by end-users for use in practice? The purpose of this project was to create and evaluate a CPG to increase early detection and intervention for suicidal risk. I used the Johns Hopkins Evidence-Based Practice (JHEBP) model to review 14 sources spanning evidence Levels I-V. Literature was obtained from CINAHL, PubMed, Cochrane, and PsycINFO to ensure comprehensive coverage. A panel of four content experts assessed the guideline using the AGREE II instrument. All domain scores surpassed the 70% quality threshold, ranging from 76% to 88%. The first global assessment item received unanimous ratings of 7 (strongly agree) from all reviewers, indicating the highest possible quality rating, and the second item received full endorsement for implementation. The social significance of this project was demonstrated by the standardization of the C-SSRS tool, which aimed to improve early detection and management of suicide risk and to promote a consistent assessment approach for older adults.

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