Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Anna Tabet


Suicide is the 10th leading cause of death in the United States with over 47,000 people dying in 2017 from suicide alone (NIMH, 2019). In the United States, one in three people who die by suicide were seen by a behavioral health provider within the same year (McCabe et al., 2018). The purpose of this project was to determine if suicide screenings and safety plans are being completed and documented properly; how many patients are refusing to complete the patient health questionnaire (PHQ-9) and is there a pattern present in these patients. Objectives are to improve the rates of suicide risk screening, safety plan documentation, decrease patient refusals, and determine if a pattern is present. The aims of this project are to determine the rate of suicide screenings and suicide safety plan documentation and increase rate to 95%; determine rate of patient questionnaire refusals and decrease by 10%; and implement alert system for 100% of patients at risk for suicide. The project was implemented over a 10-week period of which two psychiatric nurse practitioners participated. Results indicate that there was a 15% decrease in screening and safety plan documentation; 100% of patients at risk for suicide had an alert placed; PHQ-9 refusals decreased by 27%, however, 25% of patients were not asked to complete the PHQ-9 once providers switched to tele-visits. A pattern was observed in patients who refused to complete the PHQ-9.