精神科自殺警示與通報系統之研究

The Study of Suicide Alerting and Reporting System in Psychiatric Department

自殺已成為整個社會所關注的焦點，更是醫學界所要預防的對象之一，從1997年自殺進入國人的十大死因排名內，目前精神科臨床預防自殺方法仍以評量表收集病患資訊，依照不同程度的危險性給予不同的預防措施，但這樣子的評估資料卻無法持續性的給予預測值，易導致醫療人員鬆懈了對病患的自殺防範處置。本研究建置一套精神科自殺警示及通報系統，系統透過評估量表的輸入及持續性的臨床交班評估 單的病患現況，自動計算出所得分數，並顯示出每位病患的量表警示燈號，及個別病患自殺程度值，主要提醒臨床工作者隨時注意病患自殺想法與行為，以期許能達到持續性及有效性的預防自殺之目標；系統另有對外通報之作用，針對因自殺到院急診治療或在住院期間，出現有自殺行為的病患資料需進行外部通報時，系統可自動將通報表單編碼產生HL7自殺通報訊息，讓自殺防治中心得以快速進行病患資料分析後，透過訊息通知給其他院所或自殺防治小組，以協助防範病患再次出現自殺行為，進而達到外部通報之實質效益。

Suicide, the issue which has already drew much concern from the society, its prevention is one of top priorities of the health science. Since 1997, suicide has entered the list of top ten major causes of death in Taiwan and leapt to the ninth in 1999. In recent years, the mortality rate in Taiwan showed an increase trend. Therefore, more manpower and resources are required to invest in suicide prevention. We have established a 'Suicide Alert and Reporting System in Psychiatric Department' in this research. In this system, through the input of suicide and depression assessment results and data of patient's current condition on his nursing record, when the user logs into the system, it will automatically calculate the suicide risk based on scores of suicide scale, depression scale and patient's current condition. It will also display warning symbols and suicide risk value for each individual patient to remind the staff to pay attention to the patient's, aiming to reach the goal of continuous and efficient suicide prevention. In addition, the medical staff can choose individual patient's assessment result and the system will calculate the continuous suicide trend to provide reference to interventions of suicide prevention. Moreover, the system has additional function of external report. When a patient is treated in emergency room for suicidal behavior, or exhibits suicidal behavior during admission in the hospital, this system can automatically encode the patient's information to an HL7 message and report to the Suicide Prevention Center. The Suicide Prevention Center can rapidly analyze the patient's information and notify other institutes or suicide prevention groups for preventing further suicide.