Document Type


Publication Date


Date of Final Presentation


Committee Chair

Kim Martz, PhD, RN

Committee Member

Jane Grassley, PhD, RN, IBCLC

Optional Additional Committee Member

Pamela Gehrke, EdD, RN

Coordinator/ Chair of DNP Program

Pamela Strohfus, DNP, RN, CNE

Abstract/ Executive Summary

Background/Purpose. Numerous studies indicate that nurses and other healthcare professionals receive little or no suicide-related education or training. Unfavorable attitudes about suicide can also negatively influence caregiver behaviors and impact patient care. Evaluations of Applied Suicide Intervention Skills Training (ASIST) as a gatekeeper training intervention consistently demonstrate enhanced knowledge, more favorable attitudes, and increased intervention skills. This project aimed to conduct a small-scale pilot of ASIST for hospital nurses, effect suicide education policies, and prevent suicide sentinel events at the project site.

Design. A single comparison group pre/post testing design was used.

Methods. A combination of purposive and network sampling was used to recruit nurses and other professional disciplines within a regional healthcare system in Upstate New York. Pretest and post-test questionnaires were used to collect primary quantitative data to evaluate suicide-related knowledge and attitudes, and satisfaction with ASIST. Descriptive statistics and frequencies were performed for demographic, professional and personal experience with suicide, prior suicide education/training and satisfaction with ASIST. Paired t tests were performed to determine differences in suicide-related knowledge and attitudes.

Results. Thirty participants completed the ASIST intervention, 29 completed the pre and post-test questionnaires. Mean post-test scores for knowledge and attitude increased by 13.1% and 11% respectively. Satisfaction scores for ASIST exceeded the desired outcome threshold. This small-scale pilot of ASIST supports a case to advance organizational suicide training efforts. The voluntary participation of non-nursing professionals such as social work, pastoral care, academia, and behavioral health, affirms the larger need for workforce development. The under-representation of nurses participating in this suicide education process corresponds to the Adapt phase of the Adopt, Adapt, Evolve framework to develop clinical competency across disciplines and speaks to a need for long-term system change.

Conclusions & Implications. With the persistence of suicide as a leading cause of death, having a competent clinical workforce is critical to prevention efforts. Accomplishing this goal will require efforts on multiple levels. Health care systems must be willing to commit the necessary resources to support organization-wide policies and procedures to mandate cross-discipline suicide prevention training. Mandatory staff development and continuing education for license renewal can serve as vital catalysts for individuals, disciplines, and employers and drivers of policy change.