Using the Self-Mutilation Assessment Tool “SLICE” for Emergency Room

Tuesday, 14 July 2009: 8:30 AM

Karen Hamilton, PhD, RN
Kimberly A. Williams, DNSc, APRN, BC
Katherine A. Bydalek, PhD, FNP-BC
Community Mental Health, University of South Alabama College of Nursing, Mobile, AL

Learning Objective 1: 1. To determine two signs and symptoms of self-mutilations in the Emergency Department

Learning Objective 2: 2. To identify how the SLICE tool can be used in Emergency Department settings.

Purpose: The aim of this study is to use a new assessment form to identify risk factors of self-mutilation in adolescents and adults. Application was focused on Emergency Department settings.

Methods: Risk factors were reviewed using an EBSCO data base search and were categorized under each section of the Scars, Links, Injuries, Clothing, and Environment (SLICE) assessment tool. Opinions of 5 psychiatric and other professionals of different disciplines were reviewed for construct reliability and used for identified needed revisions.  The tool was tested for inter-rater reliability.


Minimal changes have been required for the assessment tool after review from Psychiatric Professionals.  Inter-rater reliability reported good reliability.


The SLICE tool can be used in the emergency department setting for early diagnosis and intervention. Further study using multiple discipline settings and cultures are needed.