Date of Conferral
8-6-2026
Date of Award
August 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Susan Huehn
Abstract
This doctoral project was an organizational change initiative designed to implement a standardized suicide risk screening process in an outpatient psychiatric practice. The identified practice problem was inconsistent staff use and documentation of suicide risk screening, which could result in missed warning signs, delayed provider notification, incomplete documentation, and inconsistent follow-up care. Suicide risk identification is an essential nursing responsibility and a key component of patient safety (The Joint Commission, 2024; Zero Suicide, n.d.). The practice-focused question examined whether staff education and implementation of a standardized Columbia-Suicide Severity Rating Scale (C-SSRS) workflow would improve staff compliance, documentation completion, and knowledge related to suicide risk screening. The project used deidentified aggregate data from chart audits and staff knowledge assessments. Pre- and postimplementation results were analyzed using descriptive statistics. Results demonstrated improvement in all outcomes. Staff compliance with completing the C-SSRS increased from 40% to 90%, documentation completion increased from 43% to 87%, and staff knowledge increased from 60% to 100%. Major project products included staff education, a standardized screening workflow, a chart audit tool, and a knowledge assessment. The findings suggest that staff education and a standardized workflow improve suicide risk screening consistency in outpatient psychiatric practice. The project supports evidence-based nursing care, patient safety, and positive social change by promoting consistent screening and follow-up for psychiatric outpatients (Columbia Lighthouse Project, n.d.; The Joint Commission, 2024; Zero Suicide, n.d.). Background Suicide risk screening is an essential component of psychiatric care because early identification of individuals at risk is central to suicide prevention and patient safety (The Joint Commission, 2024; Zero Suicide, n.d.). Patients receiving care in outpatient psychiatric settings may present with depression, anxiety, trauma-related symptoms, bipolar disorder, substance use concerns, psychosis, psychosocial stressors, or other mental health conditions that may increase vulnerability to suicidal ideation or behavior. Because outpatient psychiatric practices often provide ongoing medication management, psychotherapy referrals, and follow-up care, staff must have a reliable process for identifying suicide risk and communicating concerns to the provider. The practice gap identified for this project was inconsistent staff use and documentation of standardized suicide risk screening. Prior to implementation, suicide risk screening was not completed consistently for all psychiatric outpatient patients. Documentation practices also varied, which created challenges in tracking screening completion and ensuring that risk findings were clearly communicated. Inconsistent screening may lead to missed opportunities for early identification, safety planning, referral, or timely provider intervention, which aligns with national safety concerns about reliable suicide risk identification and follow-up (The Joint Commission, 2024; Zero Suicide, n.d.).
Recommended Citation
Frimpong, Dela Mensah, "Implementation of a Standardized Columbia-Suicide Severity Rating Scale Screening Process in an Outpatient Psychiatric Practice" (2026). Walden Dissertations and Doctoral Studies. 20562.
https://scholarworks.waldenu.edu/dissertations/20562
