Health and Medical Administration Commons^™

Effects Of A Compassion Fatigue Workshop On Psychiatric Mental Health Nurses, Johnnie Elizabeth Bower Bsn, Mary Johnson Dnp

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

BACKGROUND: Compassion fatigue (CF) is a collection of symptoms associated with exposure to traumas experienced by other people. Nursing is one of the professions that experiences CF from recurrent exposure to patient and family distress and from potential acts of abuse at work. Nurses working in behavioral health are one of the highest at risk for CF. Of newly graduated behavioral health nurses, 17.5% leave the field after one year and 33.5% leave after two. Signs of CF include hopelessness, feelings of inadequacy, anxiety, depression, fatigue, and increased absenteeism. Training in self-care techniques and mindfulness builds nurse resilience and …

Implementation Of A Screening, Brief Intervention, And Referral To Treatment Protocol For Treatment Of Opioid Use Disorder In Post-Carceral Populations, Adaora Ede, Mary Johnson

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

BACKGROUND: Opioid use disorder (OUD) is a pressing public health issue in the US affecting marginalized populations the most. Within the correctional setting, 65% of inmates are affected with OUD, worsening health outcomes when untreated.

LOCAL PROBLEM: This evidence-based practice (EBP) project targeted justice-involved individuals with co-occurring OUD at a behavioral health clinic in Johnson City, Tennessee. This project aimed to improve outcomes related to recidivism and relapse through clinician education and the implementation of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol.

METHODS: Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was the guiding EBP model for the …

Mindfulness-Based Educational Module For Nurses Caring For Pediatric Mental Health Patients, Brianna Mai Desjardins, Katherine Marie Newnam

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

BACKGROUND: Emergency pediatric nurses have the added stress of not only caring for medical patients but must also care for patients experiencing mental health issues. Many nurses feel unprepared to care for this specialized patient population. To bridge this gap, mindfulness-based interventions (MBIs) have been shown to provide nurses with the skills needed to care for mental health patients. This same concept can be applied to pediatric patients. Pediatric-focused mindfulness-based techniques can be used to help pediatric patients manage their symptoms.

LOCAL PROBLEM: The setting for this project was an urban pediatric emergency department in East Tennessee. At the state …

Identifying Risk And Improving Outcomes: Application Of The Gad-7 Screening Tool Used Among Patients With Chronic Pain In An Outpatient Setting, Connor J. Cochran

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

Background: It is estimated that chronic pain affects one in every five adults and that one in every three adults will be diagnosed with an anxiety disorder within their lifetime, indicating an overlap in both chronic pain and anxiety. Early identification of anxiety in the outpatient setting has the potential to increase identification and referral rates to specialized care.

Local Problem: An outpatient primary care facility that treats patients with chronic pain located in Philadelphia, Pennsylvania was the project setting. Prior to implementation, there was no standard process for identifying anxiety in patients.

Methods: The Iowa model of Evidence-Based Practice …

The Effect Of Focused Client Education On Case Management & Readmission Rates In Homeless Individuals With Co-Occurring Disorders Admitted To A Jail Diversion Program, Pallavi Rao, Mary Johnson

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

Background: Individuals with both mental illness(es) (MI) and substance use disorder (SUD) occurring simultaneously are known as having co-occurring disorders (COD). The rates of COD found among homeless individuals (H-COD) are higher than in the general population. The presence of both conditions prevents H-COD individuals from overcoming their hardships and places them at a higher risk of being involved in the criminal justice system.

Local Problem: Jail diversion programs (JDPs) admit a high rate of H-COD clients nationally and locally at the project site in Knoxville (JDP-K). The Office on Homelessness reported about 80% of those admitted to JDP-K are …

How Nurses Perceive Their Task Load When Caring For Behavioral Mental Health Patients In The Pediatric Emergency Department, Emily Cameron, Robert Cornette

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

Abstract

Introduction: Pediatric behavioral mental health patients are being seen more frequently in the emergency department setting. With this ever-growing number of cases comes the need for trained staff, including registered nurses, to care for these children during a mental health crisis. With this increase comes increased stress of nurses’ workload. The purpose of this project was to identify nurses’ perceptions of their workload when completing three identified tasks: communication, procedures, and initial intakes. Methods: The National Aeronautics and Space Administration (NASA) Task Load Index tool was used to measure nurses’ perceptions of how difficult each task was to complete. …

Effectiveness Of An Evidenced-Based Cognitive Behavioral Therapy Intervention For Adolescents In A School Setting, Sarah Ellen Gray, Kimberly Michaela Carter, Amanda Harper

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

Abstract

The adolescent years are a formative time when rapid hormonal and physical changes stimulate the developing mind. Exposure to poverty, abuse, violence, and lack of peer and social support causes an increase in vulnerability to the development of mental health problems. The COVID-19 pandemic has also exacerbated symptoms of depression and anxiety. Regardless of the risk factors, anxiety and depression continue to be significant health problems, affecting thousands of adolescents yearly in the United States. The first-line treatment recommendation for managing anxiety and depression symptoms is cognitive behavioral therapy (CBT). However, access to a provider for CBT treatment is …

Adverse Childhood Experiences Screening Among Adults In An Inpatient Behavioral Health Unit, Erika Y. Bales, Allyson Neal, Brittany Mcgill

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

Adverse childhood experiences (ACEs) are common amongst people of all ages, races, and socio-economic statuses. The consequence of ACEs impact ones mental and physical health and life span. High ACE scores lead to increased risk of suicide, depression, anxiety, and substance abuse. The purpose of this project was to screen adults admitted to an inpatient psychiatric hospital for ACEs. This project sought to determine if there is a relationship between overall ACEs score and impact on health versus length of stay. Ultimately, the aim is to reduce negative health outcome for patients as measured by length of stay. The results …

Implementation Of The Brøset Violence Checklist For Adult Psychiatric Patients, Brandy R. Cauthen, Jude Campbell, Brittany Mcgill, Allyson Neal, Stephan Haaquist, Courtney Glissen

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

Violence has become an increasing issue in healthcare systems worldwide, especially in inpatient psychiatric units. Violence can lead to harmful effects for patients and staff members and has been shown to increase the risk of depression, anxiety, and suicide. Additionally, violence has been shown to lead to staff burnout, which in turn leads to poorer patient outcomes. This project aimed to decrease rates of violence by implementing the Brøset Violence Checklist (BVC), a screening tool that predicts imminent violence. The BVC is a six-item checklist that allows patients to be scored based on behaviors. Then, a sum score is produced, …

Utilization Of A Drug Use Screening Assessment: A Quantitative Study To Reduce Benzodiazepines In Inpatient Detoxification, Malerie Lazar Bolinsky, Mary Johnson, Sarah Devault

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

The use of benzodiazepines in the inpatient psychiatric setting is common for patients undergoing drug and alcohol detoxification but does not come without risks. Too high of a dose of benzodiazepines are often administered during detoxification when patients are not adequately assessed on admission. Current literature supports utilization of a screening tool for drug use can reduce unnecessary benzodiazepine use. This study implemented the Drug Use Screening Tool in a drug and alcohol detoxification unit of inpatient psychiatric hospital to evaluate severity of drug use on admission and established a statistically significant reduction in the use of as-needed benzodiazepines prescribe.

Overcoming Barriers To Implement Depression Screening Post-Stroke, Cameron Haeseker, Erin Morgan, Eric Wilson

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

Abstract

Background

One-third of all stroke survivors are expected to develop post-stroke depression, which is linked to lower quality of life, impaired recovery, increased risk of recurrence and an overall increase in mortality (Robinson & Jorge, 2015).

Objectives

Despite this link, outpatient clinics including the stroke clinic of focus do not consistently use a formal depression screen. Therefore, a pilot project utilizing the framework of the IOWA Model of Evidence Based Practice to implement this American Stroke Association recommended guideline may result in a permanent adoption of screening (Iowa Model Collaborative, 2017).

Purpose

The purpose of this evidence-based practice project …

Advancing The Care Continuum For The Homeless: A Shelter-Based Care Coordination Project Focused On Mental Health, Alexandra H. Sain, Allyson Neal Dr, Deborah Nichols Mrs.

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

Advances in the care continuum are crucial for those with serious mental illness, especially those homeless individuals in the community. Schizophrenia is a leading cause of re-hospitalization and disability, accounting for billions of dollars spent in the United States. A prominent city shelter reports the prevalence of schizophrenia among its guests, and the community recognizes homeless shelters as the greatest source of 911 calls with countless surrounding emergency department visits. This project’s purpose is to implement a shelter-based, internal process to identify these high-risk guests and increase their subsequent care coordination services. Outcomes reflect individual benefits with increased shelter-based contacts …

Computer-Based Learning For Opioid Use Disorder, Jordan Taylor Bentz, April Snell

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

Over the last several decades, the prevalence of Opioid Use Disorder (OUD) has escalated in the U.S., leading to an opioid epidemic that ravages the wellbeing of the nation. Despite all alleviating efforts, opioid-related morbidity and mortality continue to rise across most states, including Tennessee. Currently, medication-assisted treatment (MAT) is the most highly regarded method of treatment for OUD; however, MAT programs differ significantly on the pharmaceutical agent of use, adjuncts to treatment, and philosophy of care. Unfortunately, this inconsistency often leads to poor treatment retention in MAT programs. This project aimed to improve MAT retention for patients with OUD …

Promoting Nurse Well-Being During A Global Pandemic Through The Community Resiliency Model, Sherissa Manganello

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

Since the COVID-19 pandemic started a few years ago, there has been an increase in mental health issues due to the chronic emotional, physical, and psychological stress that everyone has had to endure. COVID-19 has had long-lasting consequences on the entire healthcare system, especially with nurses as the foundation for providing quality patient care. While nurses are the trusted professionals, they also have one of the most emotionally and physically demanding careers (Ward-Miller et al., 2020). In addition, there is a global health crisis of nursing shortages that continues to grow through COVID-19, which directly affects patients’ quality of care …

A School-Based Cognitive Behavioral Progrm To Improve Adolescent Mental Health, Amanda Harper

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

Problem. While anxiety and depression are prevalent in the adolescent population and can have significant long-term consequences, treatment rates remain low. The gold standard for treatment is cognitive behavioral therapy (CBT), but this is often unavailable.

Methods. This project aimed to increase access to CBT through a school-based program. Students from a local homeschool cooperative participated in the Creating Opportunities for Personal Empowerment (COPE). Measures of anxiety and depressive symptoms were collected at baseline, after the program, and one month after the program. A Friedman test was used to evaluate medians’ differences on the screening tools at all three time …