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College of Nursing and Midwifery News

Student spotlight - Penny Sweeting

While Lecturer in Nursing and PhD student, Penelope Sweeting, has always been passionate about inpatient safety, learning about inpatient suicide for her PhD thesis has been an eye-opening experience.

“To be honest, I did not picture myself studying suicide or using human factors when I envisioned doing my PhD,” said Ms Sweeting.

Penelope Sweeting

“But when I looked into the issue, I realised it was a really big problem, and no one was talking about it.

“I started reading stories of people who had tried to take their own lives but had survived, and how grateful they were to have had a second chance at life.

“This made me realise that more needed to be done to prevent these tragic deaths.”

The overall objective of Ms Sweeting’s PhD project is to contribute to the elimination of preventable suicides in hospitals.

According to the Australian Government Productivity Commission, inpatient suicides are considered a sentinel event, wholly preventable and resulting from hospital system and process failures. It is this premise, that the most serious adverse events result from multiple concurrent failures, that forms the basis for this study.

“Essentially my study is designed to identify individual and system failures that contribute to patients' ability to take their own life while they are receiving treatment in a hospital,” says Ms Sweeting.

“Based on preliminary findings, close to forty people take their own life while receiving inpatient hospital treatment every year in Australian public and private hospitals.

“These preventable deaths represent a failure in the healthcare system to keep patients safe.  

“Inpatient suicide is a healthcare challenge that is poorly understood and understudied. I am using a unique method to analyse coroners' cases of inpatient suicides to identify areas where improvements can be made and hopefully contribute to the prevention of inpatient suicides.”

Using the error causation theory proposed by James Reason, Ms Sweeting’s PhD will demonstrate that inpatient suicide, just like all healthcare sentinel events, occurs because of the combined effect of multiple systems and process failures.

“To do this, we will use a new approach to suicide prevention, applying a human factors framework, the Human Factors Analysis and Classification System- Healthcare (HFACS), to establish the individual and system failures that have contributed to preventable suicides in Australian hospitals.

“In doing so, we will determine the common failure types and the trajectories they follow and use this information to make strategic recommendations for future suicide prevention strategies and policies.

“The evidence generated from this study will enable effective prevention strategies to be developed that will focus on the causal factors that collectively and directly impact the individual working at the grassroots level with the patients.”

While she concedes that some people will disagree with her position, believing suicides to be unpredictable and therefore unpreventable, Ms Sweeting argues we at least need to try.

“By washing our hands of the issue, it feels like we are giving up and I think we need to start focusing on what we can do rather than what we can't do.

“I am concerned that most people underestimate the extent of the problem. Hospitals should be a safe place for patients, especially when they are admitted against their own choice.

“No one should die in a place that should be affording them safety and care.”

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