Date of Conferral
8-4-2026
Date of Award
August 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Susan Huehn
Abstract
Suicide risk may fluctuate throughout treatment, making ongoing assessment essential for timely identification and intervention. At the project site, an adult outpatient behavioral health practice, the Columbia–Suicide Severity Rating Scale (C-SSRS) was administered consistently at intake but inconsistently at follow-up visits, creating gaps in suicide risk reassessment and documentation. The purpose of this quality improvement project was to evaluate the effect of standardized implementation of the C-SSRS during intake and follow-up visits on suicide risk screening compliance over a 9-week period. The practice-focused question asked how standardized implementation of the C-SSRS, compared with current practice, affected suicide risk screening compliance over 9 weeks. Guided by the Johns Hopkins Evidence-Based Practice Model and the Zero Suicide framework, a standardized C-SSRS workflow was implemented for all intake and follow-up visits, supported by staff education and periodic chart audits. Deidentified preimplementation and postimplementation chart audit data (N = 50 each) were analyzed using descriptive statistics to compare screening compliance, documentation completeness, and provider adherence. Suicide risk screening compliance increased from 64% to 96%, documentation completeness improved from 68% to 96%, and provider adherence rose from 62% to 94% after implementation of the standardized workflow. These findings support standardized, tool-based screening as an effective strategy for improving suicide risk identification in outpatient behavioral health settings. The implications for positive social change include promoting equitable and consistent suicide risk assessment for adult behavioral health patients regardless of demographic characteristics, psychiatric diagnosis, or socioeconomic status, thereby supporting earlier identification and timely intervention for individuals at risk of suicide.
Recommended Citation
BOMA, MIRABEL NGWE, "Improving Suicide Risk Identification Through Standardized Implementation of the Columbia–Suicide Severity Rating Scale (C-SSRS) in an Adult Outpatient Behavioral Health Setting" (2026). Walden Dissertations and Doctoral Studies. 20541.
https://scholarworks.waldenu.edu/dissertations/20541
