Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Julie M. Brandy


The Center for Disease Control ranked suicide as the second leading cause of death for American adolescents (2015). This crisis of adolescent suicide warrants evaluation and improvement of current suicide prevention practices. The Emergency Department (ED) offers 24-hour services and may be the only organized healthcare for utilized by some individuals. Nurses are the front-line provider of care in the ED and this role offers opportunity to identify an adolescent with increased suicide risk. The purpose of this EBP project is to evaluate nursing attitudes toward suicide prevention by implementing the best practice screening tool for adolescent suicide risk assessment. ED nurses’ attitudes toward suicide prevention directly impacts the candor of responses from adolescents during the risk assessment. This project evaluated ED nurses’ attitudes toward suicide prevention utilizing the Attitudes to Suicide Prevention (ASP) scale which collects information specific to front-line health professionals. A mandatory class emphasized the current crisis of adolescent suicide and the best evidence recommendation for implementation of the Ask Suicide-Screening Questions (ASQ) risk assessment tool. The ASQ was implemented as a practice change to be completed by ED nurses for all adolescents seeking treatment in the ED. Evaluation of ASQ results followed one month of implementation and results were compared to previous practice data. Seven positive risk screens for adolescents seeking treatment for complaints unrelated to psychiatric or suicidal origin were identified with one month of ASQ implementation. This finding would have been unrecognized with prior practice standards. These results were relayed to staff. A post-intervention ASP survey was voluntarily completed by ED nurses to evaluate a change in nursing attitudes. With the implementation of an educational event and the successful implementation of a new screening tool, improved ED nursing attitudes toward suicide prevention were demonstrated. Results indicated a more positive staff attitude towards suicide prevention, but were not statistically significant (p > .05). Data demonstrated an increase in the number of adolescents identified with an increased suicide risk. Based on these results, implementing the ASQ demonstrated an improvement in adolescent suicide risk assessment practice and nursing attitudes toward suicide prevention in the ED.