Medicine and Health Sciences Commons^™

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Implementation Of A Daily Engagement System Board (Desb) To Improve Hospital Staff Communication, Catherine Villanueva

Master's Projects and Capstones

Implementation of a Quality Improvement (QI) project to help improve staff communication between shifts at an Inpatient Acute Psychiatric Unit was determined to be of immense need. This unit is part of a large acute medical hospital. Currently, the end of shift report consists of a verbal report along with a robust printed end of shift report consisting of shift related information. This printed end of shift report can have as many as seven to nine pages thus causing information overload and decreases prioritized patient information. Furthermore, missed information or too much information can be provided in the verbal shift …

Improving Firefighter Health Through Education In Sleep Science, Elisabeth J. Filiss

Master's Projects and Capstones

Sleep impacts all aspects of life, from mental health to physical well-being to job performance. Nowhere is this more important than in the fire service, where extreme working conditions are the norm. One of 44 stations in a large fire department (XFD), Firehouse X, has 21 full-time members, six on duty per shift. A microsystem assessment of Firehouse X revealed poor sleep habits and environmental factors that are not conducive to quality sleep. The role of sleep in the fire service has recently been examined, and interventions aimed at improving firefighters’ sleep have been recommended.

This quality improvement project implemented …

The Effectiveness Of Mindfulness-Acceptance-Commitment Therapy To Decrease Anxiety And Stress In College Athletes, Breana Hunt, Samantha Bauer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Elite athletes experience up to 640 stressors daily that can impact their mental health, such as injuries, inadequate financial support, and team dynamics. The NCAA found that female athletes endorsed feeling overwhelmed with anxiety, mentally exhausted, and feeling overwhelmed by all they have to do two times more likely than their male counterparts. Current research suggest Mindfulness-Acceptance-Commitment (MAC) therapy is more effective in improving mental health in athletes compared to other sports therapies.

Local Problem: The southeastern university’s mental health and wellness department currently follows the NCAA’s mental health practice recommendations (UT Sports, 2018). While the athletics department has …

Implementation Of A Resiliency Model Of Care For Women Experiencing Homelessness, Aneitha Marie Pratt, Jennifer Terese Arth, Danielle Wright, Allyson Matney Neal

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: The majority of homeless women have experienced trauma. Trauma correlates with adverse mental and physical health outcomes. Resilience is a learned skill associated with better mental health and quality of life. Mindfulness-based interventions can increase resilience.

LOCAL PROBLEM: The project setting was an urban shelter serving homeless adults in East Tennessee. The population of interest was adult homeless women at the shelter. Shelter staff recognized the unique needs of women and sought to help women address trauma. Project aims were (a) implement the Community Resiliency Model (CRMÒ) as a mindfulness- and somatic-based approach to increase resiliency, (b) …

Recognizing Maternal Mental Health: An Initiative To Improve Perinatal Depression And Anxiety Identification During Prenatal Visits Using A Standardized Screening Protocol, Breslin Therese Gillis, Tracy L. Brewer, Megan L. Young, Heather Moss

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Perinatal depression (PD) is a common pregnancy complication. There are several predictive risk factors for PD, including co-occurring anxiety. Mental health conditions are the leading cause of preventable perinatal deaths. Screening for depression and anxiety during prenatal visits is recommended for early identification, evaluation, treatment, and follow-up.

Local Problem: An obstetrics/gynecology clinic in East Tennessee lacked a process for screening depression and anxiety during prenatal visits. The project team established a process to screen for depression and anxiety at the 28-week prenatal visit. The aim was to screen 40% of women at the 28-week prenatal visit, with 60% of …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

Transformative Learning: Changing Nurses’ Perceptions About People In Poverty, Jacqueline Debrew

Journal of Social, Behavioral, and Health Sciences

Background: Meaningful learning experiences with clients in poverty may help nursing students change their perceptions towards those experiencing poverty and, thus, provide unbiased, nonjudgmental care when they become nurses.

Purpose: The purpose of this research was to understand what learning activities and experiences nursing students found meaningful and led to a change in prior perceptions of people in poverty.

Methods: Guided by Mezirow’s Theory of Transformative Learning, accelerated BSN students enrolled in a mental health nursing course (n = 14) were assigned reflective journals throughout the semester on their assigned clinical experiences, which were analyzed for emergent themes.

Results: …

Improving Mental Health Outcomes For Amputees, Zachary Elmore

Dissertations

Problem: depression, anxiety, and other mental health disorders are more commonly diagnosed in the amputee population related to changes in mobility, activities of daily living, and quality of life (Turner et al., 2020.) As the amputation population is projected to reach over 3 million Americans in the next 25 years, additional screening is imperative to identify patients at high-risk for mental health deterioration (Ziegler-Graham et al., 2018).

Methods: this was a project that included screening all patients with the Personal Health Questionnaire for Depression (PHQ-8) meeting the inclusion criteria of being admitted to 7500 Vascular Surgery at Barnes-Jewish …

Implementing A Brief Intervention For Smoking Cessation In An Inpatient Psychiatric Facility, Erika Gotway

Dissertations

Abstract

Problem: Smoking is a leading cause of various preventable diseases, and those who experience mental illness smoke cigarettes at a higher rate than the general population. Brief intervention is a type counseling that has proven successful in encouraging smokers to quit. The “5 A’s” is a type of brief intervention which stands for: Ask, Advise, Assess, Assist, Arrange. Addressing the smoking epidemic among individuals with mental illness is not only essential for improving their overall well-being, but also for reducing health disparities and enhancing the effectiveness of existing mental health interventions.

Methods: The approach to this project was a …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

Improving Identification Of Complicated Alcohol Withdrawal Syndrome Using The Prediction Of Alcohol Withdrawal Severity Scale, Kristin Hagopian

Dissertations

Problem: Individuals who drink alcohol excessively are at great risk for alcohol withdrawal syndrome (AWS) when hospitalized. Symptoms and their severity differ for everyone, and research shows that the identification and treatment of AWS is challenging and often inadequate. Mild AWS is often overtreated, while moderate to severe AWS is often underdiagnosed and undertreated, placing individuals at risk for longer hospital stays, more time needed in critical care units, and a variety of unintended consequences.

Methods: This evidence-based practice project had a pre-post intervention design in which the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) was implemented to promptly identify …

Restraint Reduction Using The Brøset Violence Checklist, Deanna Kappelmann

Dissertations

Abstract

Problem: Patient aggression, restraint usage and assaults against healthcare workers have numerous negative health outcomes. Patient aggression and restraint usage on inpatient psychiatric units can be identified early with imminent violence predicative tools such as the Brøset Violence Checklist (BVC), where patient de-escalation interventions can subsequently occur.

Methods: This quality improvement project was conducted using a cohort design with a retrospective and prospective chart review. The IHI PDSA model was used for this project. The BVC was administered to male and female patients ages 18 to 64 years old on the adult inpatient psychiatric unit during the implementation period. …

Reducing Stress And Improving Mindfulness Practices Among Mental Health Professionals Through Guided Meditation., Liara G. Patton

Doctor of Nursing Practice Papers

Abstract

Background: Chronic exposure to psychological stress places mental health providers in a vulnerable position when coping skills are not learned or available. Mental health providers are at risk for both mental and physical illness due to the empathetic demands of their client’s stressors. The deficit in adequate coping skills can cause provider-client relationships to suffer and create an undesirable work environment.

Setting: This project took place in Somerset, KY, at a mental health company called A New Beginnings Achievement Center (ANBAC). Twenty-six employees work at ANBAC, all of whom are involved in providing mental health services to developmentally delayed …

Implementation Of A Mobile-Based Mindfulness Intervention To Lower Perceived Stress Levels In Undergraduate Nursing Students, Wendy S. Carley

Electronic Theses and Dissertations

This project analyzed the effect of the daily use of a mindfulness-based mobile application on associate degree nursing undergraduate prelicensure students’ perceived stress levels. Nursing students experience elevated stress levels that may be reduced through mindfulness behaviors. Undergraduate, prelicensure nursing students participated in establishing the impact of mindfulness on perceived stress levels in a quantitative pre/postintervention study. The evidenced-based studies chosen for this review consisted of randomized controlled trials, pilot studies, pre/posttest designs, systematic reviews, and quantitative and qualitative studies. The investigator collected presearch data using a pre/posttest design to evaluate the effectiveness of a stress management program in reducing …

Psychological Preparedness And Resilience Of Palestinians' University Staff During Covid-19 Pandemic: A Cross-Sectional Online Survey, Nizar B. Said, Mohammed Hayek, Adnan L. Sarhan, Jamal Qaddumi, Fadi Zaben, Aidah Alkaissi, Aseel Alsayed, Hammoda Abu-Odah

Palestinian Medical and Pharmaceutical Journal

Background: The COVID-19 pandemic has posed a significant threat to the worldwide population. Although several studies have been conducted targeting the diverse population, such as healthcare professionals and students, no study available to date sheds light on the academic and administrative staff who have experienced stress due to daily academic activities, such as using online platforms for teaching and learning. Objectives: This study aims to investigate the resilience and psychological preparedness of Palestinian university staff during the COVID-19 pandemic. Methods: A cross-sectional online survey mode was applied. A convenience sampling was used to present academic and administrative university staff in …

Using Self-Assessment Tools And Complementary Alternative Therapy For Chronic Migraines In Menopausal Women, Krystal Rachelle Bridwell

Electronic Theses and Dissertations

Abstract

Migraine headaches are ranked as one of the highest disabling conditions in the United States. Women who are in the perimenopausal transition phase have a higher prevalence of disabling migraines that can result in a decreased quality of life, loss of income, decreased productivity, and a higher risk for emotional difficulties. The gap in practice is the lack of education on complementary alternative medicine (CAM) and the use of a migraine diary to recognize individual symptoms as a substitute or cotherapy with pharmacologic treatments. The purpose of this scholarly project was to improve clinical practice and outcomes for perimenopausal …

Effects And Nursing Considerations For Equine-Assisted Activities And Therapies For Children With Autism Spectrum Disorders: A Literature Review, Namiko Kawamura, Mayu Sakamoto, Kayoko Machida

People and Animals: The International Journal of Research and Practice

This literature review aimed to analyze the effects and nursing challenges associated with equine-assisted activities and therapies (EAATs) for children with autism spectrum disorders (ASD). The study utilized the PubMed, CINAHL, and MEDLINE databases to identify 24 relevant articles. The effective contents were classified into two major categories: effects on interpersonal relationships, and effects attributable to the physical and emotional aspects of the lives of the children. The medical staff involved were mainly occupational therapists, followed by physical therapists and speech-language pathologists. The included studies also mention the involvement of trained equine therapists and volunteers, but not the involvement of …

Do Academic Advising And Levels Of Support Affect Nursing Students' Mental Health? A Cross-Sectional Study, Nashwa Ibrahim

Nursing

No abstract provided.

Fostering Interprofessional Collaboration In Community College Mental Health Centers: A Quality Improvement Project, Sara Jane Hamilton

Doctor of Nursing Practice (DNP) Projects

Background The worsening mental health rates among college students in the United States highlight the critical need for campuses to have high-quality comprehensive mental health centers (MHC). This necessity is particularly urgent in community college MHCs, which often lack these attributes. Local Problem An MHC within a large California community college recently introduced telepsychiatry services and is considering integrating a Psychiatric Mental Health Nurse Practitioner (PMHNP) into their team. However, knowledge gaps and limited interprofessional education (IPE) may hinder effective collaboration within the team. Methods A comprehensive literature review was conducted to assess current research on IPE, community college mental …

Improving Mental Health Support For Nursing Students Through Mental Health First Aid (Mhfa) Training Of Clinical Faculty, Amy Sands

Graduate Theses, Dissertations, and Capstones

This project aimed to implement a process improvement program at the Louisville campus of Galen College of Nursing to improve the mental health support for nursing students through the training of Clinical Instructors (CIs) in using adult Mental Health First Aid (MHFA) and the ALGEE actions described within that program.

Screening For Suicide In Veterans With Cancer, Dina E. Mcneil

Doctor of Nursing Practice Projects

Veterans are at a higher suicide risk than the general population. Veterans with cancer are at a 47% higher risk for suicide. The Veterans Health Administration has an annual suicide screening requirement, but no requirement for more frequent assessment in this high-risk population. Clinical staff may also be hesitant due to fear and anxiety, serving as a barrier to screening. The objective of this project was to educate oncology clinical staff about risk factors for suicide in veterans with cancer, the use of the Columbia-Suicide Severity Rating Scale (C-SSRS), referral processes, and local resources, and intended to increase the number …

A Behavioral Intervention Checklist To Reduce Re-Hospitalizations In Residents With Mental Illness, Jeffery Davis

Doctor of Nursing Practice Projects

Skilled nursing facilities are an essential component of the continuum of care and, with the rapidly aging population, represent an increasing cost to the healthcare system. The policies beginning in the 1960s promoting the deinstitutionalization of mental health institutions have resulted in increasing numbers of individuals with serious mental illnesses now residing in skilled nursing facilities. The complex needs of individuals with mental illness have been associated with an even greater cost of care, deficient quality, and safety concerns. This quality improvement project analyzed the impact of an evidenced-based, structured behavioral intervention checklist on rehospitalization rates in individuals with mental …

Utilization Of Depression Screening In Patients With Type 2 Diabetes Mellitus, John T. Norris Bsn, Rn, Dnp-Pmhnp Student, Robin Gordon Bsn, Rn, Dnp-Pmhnp Student, Margaret Harvey Phd, Aprn-Bc, Acnp, Chfn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes is a chronic metabolic disorder affecting millions of individuals worldwide. Research has shown that individuals with diabetes are at a higher risk of developing depression in comparison to those of the general population. Depression affects the individual's emotional well-being and has a significant impact on the management and outcomes of diabetes (Mather, 2022). This research study aims to investigate the feasibility and effectiveness of implementing the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is one the most effective assessment tools available to identify symptoms of depression (Celik, 2020).

Methods

In this retrospective chart review, at least 50 …

The Voices Of Veteran Women Shared With The World: Experiences Of Military Sexual Trauma, Kerri Alaine Qualls

Doctoral Dissertations

Through the cumulative work of this dissertation, I sought to provide a new perspective on the experience of Military Sexual Trauma (MST) through the voices of veteran women who shared their stories with the world through the internet. This approach had three sequential segments: (a) an integrative literature review, (b) an innovative methodology approach involving the application of the netnographic method, and (c) a qualitative research study. First, I present an integrative review of current MST literature. After the evaluation of thirteen studies common findings were the numerous barriers to disclosure that women veterans encountered, as well as the negative …

Discriminative Nursing Care Practices Towards Patients With Opioid Use Disorder In The Hospital Setting: How Knowledge And Social Attitudes Impact Care Delivery, Jeanne Adam Bernier

Doctoral Dissertations

Discriminative nursing care (DNC) practices towards patients with opioid use disorder (OUD) is a current phenomenon negatively affecting patient care and patient outcomes. It leads to delays in care, insufficient pain control, and feelings of guilt and shame, and it is linked to self-isolation, social isolation, social rejection, and even unemployment and housing disruption which perpetuate a dangerous cycle of inequity that is hard to overcome. In some cases, OUD stigmatization even increases morbidity and mortality rates. OUD stigmatization and discrimination are real problems in today’s health care climate due to the vast number of people affected by OUD and …

Addressing Social Determinants Of Health In Medication-Assisted Treatment Programs, Audrey Hunter

The Eleanor Mann School of Nursing Student Works

Introduction: Medication-assisted treatment (MAT) is considered the most effective treatment for patients with opioid use disorder (OUD); however, MAT program retention rates are consistently low across the United States. Addressing social determinants of health (SDOH) through text message could impact MAT retention; therefore, a pilot project at a federally qualified healthcare center (FQHC) was implemented.

Methods: The Protocol for Responding to and Assessing Patients’ Assets, Risk, and Experiences (PRAPARE) SDOH screening tool was implemented for patients undergoing MAT for OUD. Community resource referrals were provided via text message based on the screening results. Retention in treatment was measured by prescriptions …

Telehealth: A Rising Intervention For Latina Mothers Experiencing Prenatal And Postpartum Depression, Britney Gutierrez

Nursing | Student Research Posters

Abstract: Background: Postpartum depression (PPD) is high among Latina women but often goes unrecognized and untreated. Recognition and management of PPD in this population is crucial as PPD contributes to negative health effects on the mother and infant. Purpose: This research aims to look into telehealth to improve screening methods and treatment for Latina mothers through a Spanish mobile health application that will provide screening and education on PPD. Method: This mixed-method quality improvement study will include 300 participants from an OB-GYN and Pediatrics community clinic, > 18 years old, of Hispanic/Latino ethnicity, Spanish speaking, currently pregnant, or had a child …

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 …

Nursing Care Of Individuals Engaging In Non-Suicidal Self-Injury: Impact Of Dialectical Behavior Therapy Skills Reinforcement, Lucas Bridgens

MSN Capstone Projects

As explained by Linehan et al. (2006b), the seriousness of borderline personality disorder can be highlighted by the manifestations of emotional dysregulation, such as impulsive and suicidal and non-suicidal self-injurious (NSSI) behaviors. As the mental health field grows, so too does the knowledge base from which practitioners derive therapeutic interventions with hopes of effectively and safely treating patients while maintaining a culture of dignity and respect. One such treatment modality that has proven to reduce NSSI and improve interpersonal functioning, specifically in patients with borderline personality disorder, is Dialectical Behavior Therapy (DBT) which is a form of cognitive-behavioral therapy developed …