Doctor of Nursing Practice Program

Zsanett Williams, DNP, MSN, PMHNP-BC

Zsanett Williams
  • Committee Chair Name & Credentials:
    Michele Martens, DNP, RN


DNP Project Abstract

Assessing and Managing Elevated Suicide Risk in University Students

The aim of this quality improvement project was to increase implementation of the Safety Planning Intervention — a brief, evidence-based approach for the management of suicidal crises — for high-risk students seeking urgent care services at a private university counseling center.

A standardized suicide risk assessment and stratification protocol was designed to improve identification of high-risk students. To increase utilization of the SPI, a clinician delivered, patient portal-based tool was developed with bidirectional, real-time editing capacity for collaborative treatment planning. Visual reminders and EMR-based supporting tools were also devised to boost rates of risk stratification and SPI implementation during a 4-week long implementation period.

Retrospective chart review revealed that the proportion of students whose risk level was not clearly defined decreased significantly from baseline (88% to 14%; p < 0.001, OR = 0.022, 95% CI [0.006, 0.072]). Furthermore, post intervention, the rate of SPI implementation during high risk encounters increased to 87.5% (baseline: 0%; p = 0.004).

Implications for Practice
Implementation of standardized risk stratification and supporting electronic tools can improve clinicians’ utilization of the SPI in order to reduce suicidal behavior on university campuses. In the future, exploration of clinicians’ attitudes/perspectives, and EMR-based automation of risk management processes can further support attainment of project aims.