Amidst the quest to protect patients from healthcare-associated harm, acts of patient self-harm may challenge even the best-laid safety plans in unanticipated and potentially devastating ways. A query of the Pennsylvania Patient Safety Reporting System database for reports submitted from July 1, 2015, through June 30, 2018, using the event type "Patient Self-Harm" identified 624 reports describing a spectrum of events involving intentional bodily harm outside of psychiatric settings--from possession of means to self-harm to completion of a self-harm act. Emergency departments and medical-surgical units were the most common event locations, and ingestion accounted for more than 40% of the reports describing self-harm acts. A list of risk reduction strategies and resources, including the Pennsylvania Patient Safety Authority's ligature-risk assessment initiative, is provided.
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