Medicine and Health Sciences Commons^™

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

Assessment Of Conduct Disorder In Primary Care: Integrative Review, Chantel M. Kilford

DNP Qualifying Manuscripts

Conduct disorder and behavioral problems in children are the 6^th most prominent childhood health disorder within the United States of America. Early recognition and interventions have shown to improve outcomes and reduce lifelong adult sequela. Evidence suggests that primary care providers are not confident or knowledgeable about identification and assessment of the disorder. The manuscript examines the prevalence, co-morbidities, trajectories, mortality risk and outcomes of conduct disorder. Health disparities and diagnostic stigma are also addressed. Additionally, the manuscript provides primary care providers with evidence-based research and recommendations for prompt identification and screening. Conduct disorder has devasting individual, social, and …

Providing Resources To Caregivers Of Pediatric Mentally Ill Clients And Assessing For Caregiver Burden, Stacy Dee

Doctor of Nursing Practice

Background. Provision of educational and supportive resources to the caregivers of children with mental illness can help create an environment of advocacy and understanding between the child, caregiver, and provider. In depth and comprehensive learning about their child’s mental illness cannot be accomplished in a one-hour new patient appointment or established patient appointment of 20 minutes. Purpose. The purpose of this practice improvement project was to facilitate educational and community support for caregivers of pediatric clients with mental illness and evaluate if caregivers require additional support due to burden. Objectives. (a) 100% of caregivers of pediatric clients who have appointments …

Mental Health Training, Adrienne Leonard, Seanghai Lim, Emma Booth, Jaeger Mccaulou, Saori Fukuoka

Nursing Leadership in Community Engagement Projects

Introduction

New Horizons is a Seattle-based non-profit organization that serves to aid homeless youth in the greater Seattle area, with an end goal of ending youth homelessness in Seattle and King County. New Horizons has been operating since 1978 and has reached out to homeless youth of all different backgrounds in order to meet their basic needs and help transition them into a stable living environment. (New Horizons, 2016). This type of work requires staff and volunteers to be able to accommodate a wide range of cultural backgrounds, lifestyle habits, and crucially, individuals with differing mental health states and disabilities. …

Breaking Down The Impact Of Resilience On Mental Health: An Analysis Utilizing The Resilience Scale For Adults, Sydney K. Cook

The Journal of Purdue Undergraduate Research

Resilience is the capacity to recover quickly from difficulties, and previous studies have determined that resilience has a relationship with mental health. However, the association of each aspect of resilience on mental health, depression, and adverse childhood events (ACEs) have not been closely examined. Discerning which aspects of resilience are associated with mental health issues, depression, and ACEs can help psychiatric nurses determine effective treatments and interventions for at-risk patients.

One hundred ninety-five community-dwelling participants (ages 18 to 89) were invited to Purdue University in Indiana and Scripps College in California for the study. Participants completed the Resilience Scale for …

Evaluation Of Depression, Anxiety And Stress In Graduate Nursing Students, Rachel Dunston

Dissertations

Mental health issues are growing in the United States. Postgraduate school is widely known to increase the level of psychological difficulties (Dyrbye et al., 2006) experienced by students. There is a need to address mental health care in graduate nursing students. This project was a descriptive observational comparison pre-post-intervention design used to see if online modes of delivery would aid in decreasing mental health issues for nursing graduate students. Participants were provided with access to three podcasts and encouraged to use the Sanvello mobile application provided to all students at this university. The first podcast focused on using the Sanvello …

Mental Health Concerns Of Frontline Registered Nurses Associated With The Covid-19 Pandemic, Julie Ingle

Dissertations

Problem

COVID-19 caused local healthcare facilities to admit patients with COVID-19 at increasing rates, critically overloading healthcare system resources. Caregiver-related stress associated with the COVID-19 pandemic placed frontline registered nurses (RNs) at risk for mental health consequences (Havlioglu & Demir, 2020; Shechter et al.,2020).

Methods

This quality improvement project used a descriptive design to administer a collection of validated instruments assessing anxiety, depression, posttraumatic stress disorder (PTSD), and demographics. A purposive sample of RNs were recruited from the COVID-19 units in a local hospital, and the survey was distributed via email.

Results

During the implementation period (April 4, 2021-May 15, …

Mental Health Effects Of The Covid-19 Pandemic On Older Adults, Elizabeth Kerr

Dissertations

Problem: Significant psychological effects such as anxiety, depression, stress, and loneliness are shown to affect the older adult population, aged 65 years and older. The social isolation and disconnectedness related to the COVID-19 pandemic potentially worsens anxious and depressive feelings, increasing the risk for adverse outcomes in the high-risk older adult population. This project aimed to identify older adults at risk for acute, situational mental health issues associated with the pandemic.

Methods: A descriptive study design was used. Telephone interviews were conducted to explore effects of the COVID-19 pandemic on mental health responses in older adults. A convenience sample …

Identifying Adverse Childhood Experiences (Aces) In A Federally Qualified Health Center Using The Pediatric Aces And Related Life Events Screener, Melody Albarran-Slovin, Bsn, Rn

Doctor of Nursing Practice Final Manuscripts

Background: Evidence links adverse childhood experiences (ACEs) to health issues later in life. Most research has been conducted in adults but there is a lack of recent research on the impact of ACEs in the pediatric population particularly in relation to mental health conditions. Utilizing the Pediatric ACEs Screener (PEARLS) health care providers can screen for ACEs at earlier ages.

Purpose: The aim of this evidence-based project is to determine if there is an increase of newly diagnosed mental health related disorders when using PEARLS compared to not using PEARLS in the previous months before implementation.

Methods: ACEs were identified …

Balancing Provider Stress And Resilience In The Time Of Covid, Zachary Love

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice project is to improve secondary traumatic stress (STS), compassion satisfaction, and burnout amongst providers—physicians, residents, and nurse practitioners—within the acute psychiatry units of the La Jolla Veterans Health Administration (VHA) through a one-time educational training session.

Background: Mental health providers at the VHA acute psychiatry units experience one of the highest risks for the development of STS, CF, and burnout amongst all professions due to a number of individual and institutional factors. STS is characterized by secondhand traumatization with symptoms similar to that of Post-Traumatic Stress Disorder—difficulty sleeping, mood changes, upsetting images appearing …

Developing A Culturally Relevant Mental Health Assessment For Persons Of African Descent, Roberta Iyamu

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Persons of African descent have lower access to mental health care, are less likely to receive needed care, and are more likely to be misdiagnosed, experience severe disease, and to receive mental health care through primary care than non-Hispanic Whites. Context: Cultural norms related to mental health as well as the lack of culturally congruent health care delivery contribute to lower mental health care access and uptake among persons of African descent. Interventions: Campinha-Bacote’s cultural competence model and the BATHE technique provided the theoretical framework for the development and implementation of a nurse practitioner (NP) (n = 4) …

Identifying Barriers To Keeping Appointments In Mental Health, Shontel Ray

Doctor of Nursing Practice Projects

Abstract

Accessing healthcare for mental illness is important but has been challenging to resolve. Due to barriers, individuals are missing appointments leading to long-term negative effects of poor patient outcomes, such as homelessness and suicide. Understanding why individuals cancel or do not show up to their appointments is crucial to resolve this nationwide problem. Further investigation is needed to identify what barriers cause individuals to miss appointments so interventions can be created to resolve it and improve patient care. For this study, those who did not attend their first or second appointments were called and given an eight-question survey. The …

Implementation Of A Mental Health Screening In A Gastroenterology Office, Kayla Craig

Doctor of Nursing Practice Projects

The growing prevalence of depression in gastrointestinal patients is the reason why outpatient offices, gastrointestinal offices included, need to screen for mental health problems in their appointments. Many outpatient settings don't have a standard tool to screen for depression in patients, and therefore many patients are not being treated or diagnosed with depression in the process. The PHQ-9 has been shown to have strong validity and specificity in diagnosing depression in the outpatient setting.

Screening For Resilience In Pediatric Primary Care, Kaitlin Phelan, Martha Grant Fuller

Doctor of Nursing Practice Final Manuscripts

Introduction: Adversity in childhood increases risk for physical and mental health problems. Children who undergo adverse events can still flourish, due to the concept of resilience. Literature shows that resilience influences health more than adversity, and screening for resilience may improve practice.

Method: A valid screening tool for resilience, The CD-RISC, was given to children twelve and above during their well visit during February 2021 at a clinic in Oceanside, CA. Scores were categorized into four quartiles. Children responding in the lowest two quartiles received provider follow up.

Results: 97 surveys were scored: 39 scoring in the lowest quartile, 19 …

Covid-19’S Psychological Influences: How Have University Students Been Affected?, Julaby Dalman

Nursing | Senior Theses

Undergraduate students are well-known as a vulnerable population prone to stress, anxiety, depression and various other psychological problems during their academic time at university or college. With the introduction and sudden integration of the COVID-19 pandemic into the daily lives of these high-risk students, globally, many people are concerned with how the mental health of this population will be affected, given the presence of the pandemic in addition to the multiple safety measures put in place in an attempt to contain the virus. This includes students having been subjected to prolonged implementation of shelter-in-place mandates and requirements of social-distancing across …

Improving Therapeutic Communication In Mental Health Nursing: A Quality Improvement Project, Patricia A. Nill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 46 million adults in the United States (U.S.) live with a mental illness. Locally in Nevada, the psychiatrist to patient ratio is approximately 700:1, and patients are seen primarily in the inpatient setting, if seen at all, due to the wait average of 85 hours in the hospital emergency rooms for access into mental health hospitals or specialty units of a general hospital. Moreover, costs for mental health mood disorders alone are estimated at over seven million dollars annually. The Institute of Medicine (IOM) opined the need for change in healthcare to redesign practice and clinical communication with patients …

Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos

Electronic Theses, Projects, and Dissertations

In 2018, of 1.3 million Latinx adults in the United States facing concurrent issues with substance use disorders (SUD) and mental health disorders (MHD) 93% remained untreated for either diagnosis. This is concerning since Substance Abuse and Mental Health Services Administration (SAMHSA) data reveals that this population is at greater risk for suicidal thoughts, plans, and attempts. They also face structural barriers such as employment, housing, legal involvement, and insurability that further impede access to treatment.

This study’s purpose was to examine barriers to accessing treatment for Latinx populations confronting co-occurring SUDs and MHDs. This study used a qualitative design …

The Effects Of Losing A Parent On Teenagers Mental Health, Emily O'Keefe

Nursing | Senior Theses

Losing a parent is one of the hardest losses we experience. For many, the loss of a parent comes too early. Losing a parent as a teenager has lasting effects. This thesis examines the research literature review and proposes a study for further investigation about this important healthcare matter.

The mental health of teenagers who lose a parent experience worsened mental health than those who have two living parents. Bereaved teenagers experience worsened mental health, increased aggression, and an increased risk for self-harm. The research in this literature reviews, supports this, and further emphasizes the negative impact of losing a …

Scholarly Manuscript: Deficiencies In Memory And Effective Education Of De-Escalation Techniques In Mental Health Settings, Balraj Bajwa

DNP Qualifying Manuscripts

Objective: To appraise and evaluate evidence recognizing the lack of effective staff education on de-escalation techniques, the impact that this creates on nursing practice, and staff perceptions on de-escalation methods and techniques in acute care inpatient and/or outpatient mental health settings.

Methods: Three databases were searched (CINAHL, PubMed, and PsycINFO) to identify articles/reviews which focused on de-escalation techniques and training. Additionally, five journals were also reviewed to help with the search process. Specific inclusion criteria were used to streamline the search process and to help identify articles/reviews which were primarily focused on the desired objective. Five different articles …

Examining Health Disparities Among Lesbian, Gay, Bisexual, Transgender, And Queer/Questioning Adults In Davidson County, Tennessee, Samantha Anticuar

DNP Scholarly Projects

Background: Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals experience increased risks for health disparities and discrimination compared to non-LGBTQ individuals, yet there is limited research in southern populations. Purpose: The purpose of this scholarly project was to examine if LGBTQ individuals had increased health disparities compared to non-LGBTQ individuals in Davidson County, Tennessee (TN). Methods: A quasi-experimental design (N = 1,704) used the 2019 Nashville Community Health and Well-being Survey for analysis. Results: Findings suggested LGBTQ individuals had increased odds of not having health insurance (p = .009, adjusted odds: 6.84), poor mental health (p …

Implementing Best Practices To Improve Veteran’S Primary Care: A Pilot Project For Suicide Screening, Assessment & Referral, Nathaniel Held

Doctor of Nursing Practice Projects

Problem Description: Suicide is an increasing problem within the United States, but an even greater problem among the veteran population. Veterans are twice as likely to commit suicide than individuals within the civilian population. El Paso County, Colorado has the highest veteran population in the state and the highest number of suicides. Despite numerous military mental health programs available. Studies have found that many veterans will visit a civilian primary care clinic (for various reasons) within a month of taking their own lives but rarely are mental health concerns noted. This can be due to a lack of awareness and …

When Covid-19 Enters In A Community Setting: An Exploratory Qualitative Study Of Community Perspectives On Covid-19 Affecting Mental Well-Being, Naureen Akber Ali, Anam Shahil Feroz, Noshaba Akber, Rida Feroz, Salima Nazim Meghani, Sarah Saleem

School of Nursing & Midwifery

Objective: The COVID-19 pandemic has resulted in an increased level of anxiety and fear among the general population related to its management and infection spread. Considering the relevance of present circumstances, we explored perceptions and attitudes of community members towards their mental well-being during the COVID-19 pandemic.
Setting: We conducted an exploratory qualitative study using a purposive sampling approach, at two communities of Karachi, Pakistan.
Participants: In-depth interviews were conducted with community members including, young adults, middle-aged adults and older adults of both genders. Study data were analysed manually using the thematic analysis technique.
Primary outcome: The primary outcome is …

Recommendations For Perioperative Care Of Adolescents At Risk For Suicide, Rachelle Huber Dustin Rn, Bsn, Blaine A. Winters Dnp, Acnp-Bc

Student Works

Suicide is one of the leading causes of death for the adolescent population, and as such, should be addressed when adolescents have any contact with the healthcare system, including perioperative appointments. Although some surgical facilities screen patients with a history of suicide attempt or severe mental health conditions, many adolescents who have died by suicide do not have official mental health diagnoses or history of previous suicide attempt. Because of the impact surgery can have on mental health, each adolescent should be screened for suicide risk during pre-surgical consult appointments to assess suicide risk and take proper precautions, as needed. …

Depression Symptoms And Covid-19, Kaylee Armendariz

The Eleanor Mann School of Nursing Student Works

The COVID-19 pandemic presents new challenges in behavioral healthcare. Americans may face anxiety surrounding the virus, economic strain, isolation, and grief, putting them at increased risk for depression symptoms. This Doctor of Nursing Practice (DNP) quality improvement project aimed to increase depression screening rates and utilized data from a Federally Qualified Health Center (FQHC) to identify population groups at higher risk for depression symptoms during the COVID-19 pandemic. Using the Patient Health Questionnaire (PHQ) depression screening tool, a statistical analysis determined if being tested for COVID-19 or testing positive for COVID-19 had an impact on depression symptoms. Additionally, this project …

Increasing Mental Health Competency In School Nurses, Jennifer M. Walsh Msn, Cpnp, Cne

Doctor of Nursing Practice Projects

Background: Mental health concerns in the pediatric population have increased over recent years, even more so due to the COVID-19 pandemic. Time from onset of symptoms to treatment is over eight years, leaving less than 25% receiving care. Virginia ranks 47th for pediatric mental health care. School nurses spend a significant amount of workload on MH issues but often report being untrained to deal with these issues. Aims: Implement a quality improvement pilot program for school nurses designed to increase competency of identification, management, and referrals for students with mental health concerns. Outcomes measured domains of knowledge, attitude, and competency …

Mental Health Of Children And Adolescents Amidst Covid-19 And Past Pandemics: A Rapid Systematic Review, Salima Meherali, Neelam Punjani, Samantha Louie-Poon, Komal Abdul Rahim, Jai K. Das, Rehana A. Salam, Zohra S. Lassi

School of Nursing & Midwifery

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children's and adolescent's mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children's and adolescents' mental health.
Methodology: We conducted …

Negative Marital Interaction, Purpose In Life, And Depressive Symptoms Among Middle-Aged And Older Couples: Evidence From The Health And Retirement Study, Elliane Irani, Sumin Park, Ronald L. Hickman Jr.

Faculty Scholarship

Objective: Negative marital interaction and purpose in life have been associated with depressive symptoms. Yet, these associations have not been fully explored in a dyadic context. This study examines the actor (intra-individual) and partner (cross-spousal) effects of negative marital interaction on depressive symptoms in couples and the potential mediating role of purpose in life. Methods: Data came from 1186 heterosexual married couples who participated in the 2016 (T1) and 2018 (T2) waves of the Health and Retirement Study and completed the psychosocial questionnaire in 2016. Structural equation modeling was used to estimate the direct and indirect associations among T1 negative …

Rural Young Adult Health: Drivers And Barriers To Accessing Care, Maggie Thompson

DNP Qualifying Manuscripts

Adolescents and young adults are developmentally inclined to seek autonomy and take risks. This propensity for risk and challenging boundaries is essential for personal identity formation and belief systems development. During the transition to adulthood, adolescents and young adults often place a high value on peer group acceptance and adhering to perceived social norms. As a result, adolescents and young adults are more likely to engage in pleasure-seeking behaviors despite the associated risks.

The potential for harm often grows in young adulthood, as newfound freedoms present more significant opportunities to engage in risk-taking behaviors. Despite some enduring controversy, age-specific, preventative …

Letters To Ladies: An Exploration Of Nursing Leadership, Jasmine Choe

Nursing Leadership in Community Engagement Projects

This project was created by a group of five nursing students at Seattle Pacific University’s Lydia Green School of Nursing with the goal of collecting 100 handwritten letters to distribute to Angeline’s Day Center. The members of this day center have experienced changes in mental health and a lack of connectedness to their community due to COVID-19 related changes. The aim of this project was to encourage and connect with the women of the shelter during COVID-19 restrictions. Several on campus departments and clubs as well as local churches participated in writing letters that were collected and delivered to the …

The Effects Of Administrative Support On Registered Nurse Well-Being During The Covid-19 Pandemic, Cassandra Fox

The Eleanor Mann School of Nursing Student Works

Attention to the well-being of nurses is necessary to ensure the healthcare system can operate effectively, particularly during the COVID-19 pandemic. The workplace environment and support from nursing leadership strongly contribute to nurses’ well-being. Currently, there is little evidence on the effect nursing leadership has on nurses’ well-being during the COVID-19 pandemic. This DNP clinical inquiry project sought to learn more about the effects of caring leadership behaviors on nurses’ well-being during the COVID-19 pandemic. A survey composed of questions from previously validated and reliable surveys used in the field of nursing was used to collect data. Neuman’s systems theory …