Medicine and Health Sciences Commons^™

Implementation Of Prenatal And Postpartum Depression Screening For A Telehealth Company, Allison Herrmann, Lori Deibel

Doctor of Nursing Practice Projects

Abstract

Depression is a leading mental health disorder. Depression occurring during the perinatal and postpartum periods has become highly prevalent throughout the world, impacting 5-10% of women during (van de Loo et al., 2018) and 9-23.5% postpartum (Bauman et al., 2020). Proper diagnosis and treatment of perinatal and postpartum depression (PPD) is crucial, as depression can lead to poor outcomes including relationship complications and negatively affect child development (Slomain, 2019). The implementation of screening tools can help identify women at risk based on their signs and symptoms of PPD (Bauman et al., 2020). The primary goal of this project was …

Medication Assisted Therapy And First Episode Psychosis: Evaluating Treatment And Readmission Rates, Kayla Sherea Williams Bsn, Rn, Hannah Lee Brenner Bsn, Rn, Madison Makenzie Yount Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Background The Centers for Disease Control and Prevention (CDC) found that each day more than 140 U.S. residents die from drug overdoses, specifically due to opioids. Due to this, alternatives were created to reduce overdoses and ensure safety. Medication assistance therapy (MAT) is an effective form of treatment for people with substance use disorders and is defined as the use of medication in conjunction with counseling or therapy for the treatment of substance use disorders. The efficacy of MAT is used adjunctively with psychotropic medications compared to using no MAT and using psychotropic medications alone with individuals who are experiencing …

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

Second-Victimhood Among Anesthesia Providers & The Effects On Patient Outcomes, Erika Aitken

Doctor of Nursing Practice Projects

Anesthesia providers work in environments promoting productivity with tremendous pressure to begin the next case regardless of any recent adverse events that may have occurred (Wands, 2021). Certified nurse anesthesiologists (CRNAs) potentially struggle with a lack of recognition, a high number of hours, inadequate work-life balance, and limited professional advancement, which all contribute to high stress levels within the field (Andrade & Dantas, 2015). A healthcare professional involved in an unexpected adverse event, medical error, or patient-related injury is labeled as a second victim. Thirty anesthesia providers from a central Illinois hospital viewed a PowerPoint presentation, completed a survey, and …

The Utilization Of Depression Screening Tools In Patients With Diabetes Type 2, Hanna Book, Kennedy Eldridge, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Artangela Henry Dnp, Agacnp-Bc, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Diabetes and depression are highly prevalent and concerning conditions impacting millions worldwide. Evidence-based guidelines recommend regular depression screening of individuals with type II diabetes (DM2) to appropriately diagnose and treat depression and proactively enhance clinical outcomes. The gold standard for determining depression in patients with chronic disease is the diagnostic clinical interview; however, many clinicians have turned to brief, self-reported screening tools such as the PHQ-2 and the PHQ-9 whose use are recommended by evidence-based guidelines. This study aims to assess the utilization of the PHQ-2 and PHQ-9 versus no screening on DM2 patients in a primary care setting. …

Evaluating The Efficacy Of Medication-Assisted Treatment For First Episode Psychosis: A Scoping Review, Chanel Thomas Msn, Aprn, Fnp-Bc, Rn-Bc, Alexandra Wittenberg Bsn, Rn-Bc, Anttrenika Anderson Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that individuals with substance use disorder (SUD) receive medicated-assisted treatment (MAT), as a complete approach to substance use treatment (SAMHSA, 2019). However, treatment measures using combination treatment for SUD in individuals experiencing first episode psychosis (FEP) are seldom used. This scoping review assesses the efficacy of MAT in conjunction with antipsychotics compared to the use of antipsychotic monotherapy for FEP individuals on hospital readmission rates.

Methods

The authors conducted a literature review utilizing PubMed, EBSCO, Elsevier, Google Scholar, PsychINFO, and Medline from August 2020 to November 2022. Key phrases …

Depression Awareness Programs For Adolescents: A Scoping Review, Kincharska N. Freeman Msn, Aprn, Fnp-C, Cnor, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

The purpose of this DNP project is to determine if receiving school-based depression awareness education affects the depression scores of adolescents between 10 and 19 years of age.

Improving Depression Surveillance At The We Care Clinic, Kaitlin Springer, Emma Hanney

Doctor of Nursing Practice Projects

Depression is one of the most underdiagnosed and untreated disorders affecting more than 16 million people in the United States each year (Henry et al., 2020). Unmanaged depression can lead to emotional suffering, decreased productivity, reduced income, impaired relationships, and an increased risk for comorbidities (Sinisalchi et al., 2020). It can affect anyone, however, individuals who are non-white, female, undereducated, disabled, pregnant or postpartum, have low socioeconomic status, or lack social support are at an increased risk (United States Preventative Services Task Force, 2019). The Southern Illinois University Edwardsville We Care Clinic provides primary care to minority patient populations who …

Integrating Mental Health Into Primary Care, Lori Hopwood, April Schmidt

Doctor of Nursing Practice Projects

BACKGROUND: The purpose of this project was to examine the effects of a newly integrated collaborative mental health care model. The primary goal of the integrated behavioral health program was designed to increase the ability of primary care providers to provide mental health services with the support and expertise of a consulting psychiatrist and behavioral health specialist. Additional goals were to improve access to care and improve mental health outcomes.

AIMS: The aim of this project was to evaluate a new way of integrating mental health services in a rural health, primary care practice in central Illinois.

METHODS: Measures …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …

Evaluating The Use Of Long-Acting Injectables As A Method To Improve Treatment Adherence In Patients With Schizophrenia: A Scoping Review, Britney Michelle Holton Msn, Fnp-Bc, Patricia Rena Jones-Purdy Msn, Cnrn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background Medication adherence is a major issue for patients suffering from schizophrenia and medication non-adherence can lead to psychiatric morbidity. Although long-acting injectable (LAI) antipsychotics have been shown to improve treatment adherence, most clinicians continue to rely on oral therapies to manage schizophrenia. This scoping review will assess evidence-based literature to determine the relationship between the use of LAIs and medication adherence in patients with schizophrenia.

Methods A literature review was conducted between August 2020 and January 2021 to find studies that have evaluated medication adherence with the use of long-acting injectables in patients with schizophrenia. Relevant literature initially selected …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

Boarding Barriers For Psychiatric Patients In Emergency Departments, Emmeline B. Martin Bsn, Rn, Alison Rossano Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Objective To identify past or current literature about emergency department holds and psychiatric patients consisting of the evaluation of patient outcomes, satisfaction and equity of care. It is already known that shorter boarding times from the emergency department to a psychiatric unit have positive patient outcomes such as a decrease in readmissions, increase in patient satisfaction and efficiency in appropriate treatment.

Method A scoping review to analyze data by grouping articles into themes which included authors, date of publication, aims/purpose, methodology, sample, interventional details, and the key findings in each article. Excluded articles included those discussing COVID-19 and case management. …

Impact Of Ante- And Postnatal Depression Screening In Women With Hiv: A Scoping Review, Kimberly M. Grider Bsn, Rn, Pmh-Bc, Bao Chau Le Bsn, Rn, Blessing Okon Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Maternal depression has been identified as a strong predictor of poor prenatal care. Among pregnant women living with Human Immunodeficiency Virus (HIV), mental health-related factors such as depression could potentially undermine effective antiretroviral therapy (ART) adherence, increase mortality, and cause poor HIV viral suppression consequently impacting vertical transmission of HIV. This scoping review aims to identify existing knowledge regarding the impact of ante- and postnatal depression screening in women with HIV and to adduce the necessity for effective screening.

Methods A literature search was performed for studies with primary outcomes of depression screening within the context of ante- or …

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Postpartum Depression: Development Of A Screening Protocol In The Neonatal Intensive Care Unit, Kelsey T. Langdale

Doctor of Nursing Practice Projects

Postpartum depression (PPD) affects approximately 19% of all postpartum women. Evidence indicates an increased risk for mothers of hospitalized infants, with estimates ranging from 28% to 67%. The American Academy of Pediatrics and Bright Futures recommend mothers be screened for postpartum depression at the infants’ well-child appointments. During hospitalizations, there are no well-child appointments; thus, no postpartum depression screening. This project aims to 1) improve knowledge of PPD in the staff of the Neonatal Intensive Care Unit (NICU) and 2) investigate the staff’s interest level in implementing a PPD screening protocol. Utilizing the Plan-Do-Study-Act (PDSA) framework, a protocol was developed …

Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).

Methods We conducted a retrospective chart review on patients …

Efficacy Of Integrating Cbt For Mental Health Care Into Substance Abuse Treatment In Patients With Comorbid Disorders Of Substance Abuse And Mental Illness, Laura U. Madu, Jacqueline Sharp, Bobby Bellflower

Doctor of Nursing Practice Projects

Abstract: Multiple studies have found that psychiatric disorders, like mood disorders and substance use disorders, are highly comorbid among adults with either disorder. Integrated treatment refers to the treatment of two or more conditions and the use of multiple therapies such as the combination of psychotherapy and pharmacotherapy. Integrated therapy for comorbidity per numerous studies has consistently been superior to the treatment of individual disorders separately. The purpose of this QI project was to identify the effectiveness of Cognitive Behavioral Therapy (CBT) instead of current treatment as usual for treating Substance Use Disorder (SUD) or mental health diagnosis independently. It …

Improving Psychological Trauma Awareness For Culturally Responsive Care: A Dnp Project, Jose M. Cruz

Doctor of Nursing Practice Projects

Racism and racial discrimination occur in a variety of forms (Kendi, 2017). Both can contribute to poor mental health outcomes in the United States (Alvarez, Liang, & Neville, 2016; Comas-Diaz, Hall, & Neville, 2019; Levy, 2019; Malott & Schaefle, 2015; Williams, Lawrence, Davis, & Vu, 2019). These social conditions have been identified as chronic stressors that can illicit trauma symptoms, result in post-traumatic stress disorder (PTSD), and contribute to increased suicidality (French et al., 2020). Providers should understand the ramifications of the psychological trauma that can occur and endeavor to deliver evidence-based solutions. This doctoral project was designed to develop, …

A Protocol For Improving Early Recognition And Treatment Of Bipolar Disorder, Zelluyah Gaitho

Doctor of Nursing Practice Projects

In bipolar disorder, patients present to a clinician during depressive episodes often leading to a misdiagnosis. In turn, this could lead to inappropriate treatment. This failure to diagnose could be attributed to lack of use of validated screening tools and deviation from clinical guidelines. The purpose of this quality improvement project was to develop a protocol that will help improve early recognition and treatment of bipolar disorder by using the Mood Disorder Questionnaire. A training program was developed to increase knowledge on the proper use of the Mood Disorder Questionnaire (MDQ) and the Quality-of-Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). …

Best Practices For Screening, Identification, And Referral Of Female Collegiate Athletes With Disordered Eating, Brenda Caudill

Doctor of Nursing Practice Projects

Eating disorders have the highest mortality rate of any mental illness, including depression. Female collegiate athletes are at greater risk compared to the non-athlete population. Athletic personnel should be prepared to screen, identify, and refer female athletes for eating disorders. However, most staff are not familiar with common signs and symptoms of disordered eating, which could delay recognition of unhealthy behavior and ultimately long-term health risks. Appropriate screening protocols can assist with early identification. The purpose of this DNP project was improve the knowledge of the athletic staff regarding eating disorder recognition, awareness of university policy for identification and referral …

Acceptability Of Telepsychiatry In A Rural Kentucky Community Mental Health Clinic, Leslie Brauner

Doctor of Nursing Practice Projects

While telepsychiatry has been championed as a method to improve access to care and health care delivery to remote regions, the willingness of rural patients to receive psychiatric treatment via telehealth technology remains uncertain (Rohland, Saleh, Rohrer, & Romitti, 2000). Published studies concerning general patient satisfaction with telemedicine are available; however, there is little focus on satisfaction of specialized telepsychiatric care to rural mentally ill adults. A capstone project was conducted to examine the acceptability and satisfaction of telepsychiatry in a rural Kentucky mental health clinic. Patient satisfaction with the modality was assessed using the Telemedicine Satisfaction and Usefulness Questionnaire …