Date of Completion
Fall 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Dr. Anthony Schreiter
Second Advisor
Dr. Adriane Stasurak
Third Advisor
Dr. Katie Hooven
Abstract
Problem: Suicide risk assessment is a critical component of mental health care; however, inconsistent use of standardized assessment methods can lead to variability in risk identification and clinical decision-making. At the outpatient mental health project site, standardized use of the Columbia-Suicide Severity Rating Scale (C-SSRS) had not been established, indicating a practice gap.
Aim of the Project: The goal of the 12-week Quality Improvement (QI) project was to improve nursing staff knowledge, skills, competence and organizational readiness for standardized suicide risk assessment through structured C-SSRS education and implementation support.
Review of the Evidence: The C-SSRS is a standardized tool with evidence to support its use in the assessment of suicidal ideation and behavior. The literature also supports structured staff education, competency development, standardized workflows, and implementation strategies to facilitate the adoption of suicide risk screening in clinical practice.
Project Design: The project was designed using a QI design based on the Plan-Do-Study-Act (PDSA) framework and OhioHealth Change Management process. Three PDSA cycles focused on staff education and competency, clinical workflow and reinforcement and organizational readiness. Descriptive statistics were employed to evaluate the project outcomes.
Intervention: Twenty eligible staff were invited to participate in a structured education on the C-SSRS addressing administration, scoring, risk classification, documentation, safety planning, escalation and referral. Education was reinforced with case-based scenarios, return demonstration, competency validation, workflow guidance, and quick-reference resources.
Significant Findings/Outcomes: Eighteen of 20 eligible staff completed the educational training resulting in a completion rate of 90%. After education, 85% of participants met the competency standard that was set. There was no standardized competency assessment pre-education, so 85% reflected achievement of competency after education and not pre-post improvement. Organizational readiness went up from 3.48/5.00 (69.6%) at baseline to 4.37/5.00 (87.4%), a difference of 0.89 points or 17.8 percentage points.
Implications for Nursing: Structured C-SSRS education, competency validation, workflow reinforcement, and leadership support can enhance nursing preparedness for standardized assessment of suicide risk. Ongoing education and periodic assessment of competency and monitoring of clinical implementation support sustainability and consistent practice.
Recommended Citation
Gyang, Elizabeth, "Enhancing Suicide Risk Assessment using the Columbia-Suicide Severity Rating Scale" (2026). All Doctor of Nursing Practice (DNP) Scholarly Projects. 91.
https://fuse.franklin.edu/dnp-project/91
Rights
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