Degree Name
Nursing Practice, DNP
Publication Date
9-14-2026
First Advisor
Lisa Drake
Second Advisor
Beatrice Bailey
Abstract
Suicide is a leading cause of death in the United States, highlighting the need for routine suicide risk identification. Evidence supports standardized suicide screening can promote early identification of suicide risk. A needs assessment at an outpatient mental health clinic identified the absence of a standardized suicide screening and referral process. The purpose of this quality improvement project was to implement the Ask Suicide-Screening Questions (ASQ) Tool and a standardized referral protocol. The aim was to evaluate ASQ documentation, referral rates, and staff self-efficacy over four weeks. Peplau’s Interpersonal Relations Theory, Lewin’s Change Theory, and the Plan-Do-Study-Act (PDSA) framework guided the project. A quantitative, quasi-experimental pretest-posttest design using the PDSA framework was implemented with eight clinical staff. Staff received education and implemented the ASQ Tool and standardized referral protocol over four weeks. ASQ documentation and referrals were collected through electronic health record review, and staff self-efficacy was measured pre- and post-implementation using the General Self-Efficacy (GSE) Scale. ASQ documentation increased from 0% pre-implementation to 90.9% post-implementation, χ²(1) = 68.46, p < .001. Referrals were significantly associated with the implementation period, Fisher’s exact p = .005. Staff self-efficacy significantly increased from pre- to post-implementation, t(7) = −3.29, p = .013. Findings support standardized suicide screening and referral protocols at the project site. However, the small staff sample and four-week implementation period limit generalizability.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Lee, Shayla, "Enhancing Early Detection of Suicide Risk in Outpatient Settings Through Standardized Implementation of the Ask Suicide Screening Questions Tool" (2026). Doctor of Nursing Practice Projects. 403.
https://arch.astate.edu/dnp-projects/403
