Developing, implementing and evaluating a model for an outpatient self-harm service
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Developing, implementing and evaluating a model for an outpatient self-harm service

Fiona Brand Research nurse, Centre for Suicide Research, University Department of Psychiatry, University of Oxford, Oxford, England
Karen Lascelles Suicide prevention lead nurse, Oxford Health NHS Foundation Trust, Oxford, England
Aim

To reduce the incidence of self-harming behaviour in individuals who presented regularly to the emergency department in one hospital following self-harm, as well as to improve their well-being and experience of care.

Method

This was a 12-month nurse-led practice development project to develop, implement and evaluate a brief-intervention outpatient service for individuals who presented to the emergency department following self-harm and who were identified as being at risk of further self-harm. The service improvement was informed by an action research process and the principles of appreciative inquiry.

Findings

The project provided a short-term outpatient follow-up service, known as Brief Interventions in Repeat Self Harm (BIRSH), to patients who presented to the emergency department following self-harm, and who were considered at risk of further self-harm. The intervention enabled the clinician to validate the patient's distress and offer them short-term outpatient follow-up care. The BIRSH sessions were offered to 38 patients. A total of 26 patients attended one or more BIRSH session, and all of these individuals showed a reduction in the number of presentations to the emergency department following self-harm in the six months following the intervention, compared to the six months before the intervention.

Conclusion

The BIRSH outpatient service appears to have been a contributory factor in reducing self-harm for patients who engaged with the service. The service improvement was informed by an action research process and the principles of appreciative inquiry, which provided a positive, focused approach to the practice development project.

Nursing Standard. 31, 37, 46-54. doi: 10.7748/ns.2017.e10229

Correspondence

fiona.brand@oxfordhealth.nhs.uk

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Conflict of interest

None declared

Received: 20 July 2015

Accepted: 26 January 2016

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