Inpatient suicide and self-harm case review
When a patient harms themselves in a hospital or behavioral health unit, the review looks at whether suicide risk was screened and reassessed, whether the observation level matched that risk and was actually carried out, and whether the environment was safe.
What the nurse reviewer examines
- Suicide risk screening and assessment (such as the Columbia scale) and reassessment
- Observation orders (one-to-one, every 15 minutes) and the observation records
- Environmental safety: ligature points, belongings searches, sharps
- Handoffs and communication of risk between staff and units
- Emergency department boarding and medical floors caring for at-risk patients
- Response and resuscitation after the event
Records to request
A starting checklist; the reviewer will flag what's missing once they have the chart.
- Nursing notes and suicide risk assessments
- Observation flowsheets and rounding logs
- Physician and psychiatric orders
- Security and video records if they exist
- Room and unit safety checklists
- Policies on suicide risk and observation levels
Questions attorneys ask
What do observation records show?
Every-15-minute or one-to-one observation sheets record where the patient was and what they were doing. Comparing them with video, door logs and other records can show whether checks were actually done.
Do these cases happen outside psychiatric units?
Yes: emergency departments and medical floors care for patients awaiting psychiatric placement, and their policies and environment are often less suited to them.
Consultants
Consultants in these specialties review cases privately. Post a brief and the ones who match will see it first.
Post a redacted brief, compare proposals
Describe the case without names. License-verified nurses in the right specialty send proposals with their experience and rate. Records are shared only after you hire, in an encrypted workspace.