| RPT |
|.|.| Patient Safety Secondary Screener: (PSS-3 2nd)|
<*Answer_7772*>|
<*Answer_7773*>|
<*Answer_7774*>|
<*Answer_7775*>|
<*Answer_7776*>|
<*Answer_7777*>| |
Questions and Answers:| 1. Did the patient screen positive on both PSS
items - active Ideation with a past attempt?| <*Answer_7849*>|
2. Has the individual begun a suicide plan?| <*Answer_7850*>|
| Date Given: <.Date_Given.>| Clinician:<.Staff_Ordered_By.>| Location: <.Location.>
3. Has the individual recently had intent to act on his/her ideation?|
<*Answer_7851*>|
4. Has the patient ever had a psychiatric hospitalization?|
<*Answer_7852*>|
5. Does the patient have a pattern of excessive substance use?|
<*Answer_7853*>|
6. Is the patient irritable, agitated, or aggressive?| <*Answer_7854*>| |
|<*Answer_7778*>|
| |
| | Veteran: <.Patient_Name_Last_First.>| SSN: <.Patient_SSN.>| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)
Information contained in this note is based on a self-report
|assessment and is not sufficient to use alone for diagnostic purposes.
|Assessment results should be verified for accuracy and used in
|conjunction with other diagnostic activities.| |
Copyright 2015, Boudreaux, E. Reproduced with permission| | $~
| Gender:<.Patient_Gender.>|| |
<*Answer_7780*>|<*Answer_7781*>|<*Answer_7782*> | |
POSITIVE INDICATORS|
<*Answer_7771*>|
|
