Implementation Of An Agitation Scale In Three Emergency Departments In An Urban Area Of Northern California, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Background. Behavioral health patients in the emergency department are customarily treated without an objective assessment of agitation at presentation and throughout their hospital stay.

Local Problem. Behavioral health patients presenting with agitation in three emergency departments in Northern California are customarily treated with activation of a Code Grey emergency alert, use of physical restraints, or emergent sedation medication administration to manage the situation, prevent escalation, and protect the staff.

Context. Agitation in patients that is not recognized can lead to emergent sedation medication administration, physical restraints placed, and Code Greys activated to support the clinical staff.

Interventions. An evidenced-based agitation …

Behavioral Health Patients And Agitation In The Emergency Department: A Synthesis Of Literature, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Abstract

Introduction: Patient agitation is a phenomenon that presents itself to the emergency department (ED) on a daily basis. Agitation can manifest from an array of physical or psychological complaints. Behavioral health patients presenting with agitation is a growing subset of the total agitation population within EDs. A better understanding of behavioral health patient agitation in the ED setting is needed to guide best practices in treating this fragile population with therapeutic, patient-centered care.

Methods: A review of literature was conducted on agitation and behavioral health in ED settings, using the search terms emergency department, agitation, restraints, sedation, and behavioral …

Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …

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) …

A Toolkit To Assist Child And Adolescent Providers In Assessing Problematic Internet Use And Cyberbullying In An Outpatient Psychiatry Clinic, Collin J. Mcgrath

Doctor of Nursing Practice (DNP) Projects

Social media has become a transformational part of daily life in the United States. Currently, there are few assessment tools and no standard of care when it comes to assessing internet use, social media, and cyberbullying among child and adolescent patients. Problematic internet use (PIU) and cyberbullying can both significantly and negatively impact the mental health of children and adolescents. The purpose of this project is to evaluate the effectiveness of an online toolkit implementation for a Southwest Florida (SWFL) outpatient psychiatry office. A pre/post one group design was used. A convenience sample of 13 healthcare providers was recruited from …

Enhancing Therapeutic Alliances In Neonatal Care: Parents With Substance Use Disorders, Shannon A. Starkey

Doctor of Nursing Practice (DNP) Projects

Background: The number of newborns exposed to opiates quadrupled in the United States from 1999 to 2014, from 1.5 per 1,000 hospital deliveries to 6.5 per 1,000. Many of these babies are admitted to the neonatal intensive care unit for neonatal abstinence withdrawal syndrome. While neonatal nurses are trained to care for babies exposed to substances in utero, they often struggle to meet the unique psychosocial needs of the babies’ parents. Negative attitudes and strained interactions between neonatal nurses and families with substance use disorders (SUDs) result in subtherapeutic alliances and suboptimal outcomes in neonatal nurseries. Purpose: Educational …

A Quality Improvement Project To Assess The Value Of Pharmacogenomic Testing In Adults Diagnosed With Major Depression, Ileana Miranda Velazquez

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Treatment of major depression follows the guidelines from evidence-based medicine established algorithms; however, 50% of patients diagnosed with major depressive disorder do not respond to their first medication trial, and 70% may go through four treatment attempts before achieving remission.

Purpose: To demonstrate the value of pharmacogenomic testing as a treatment-guidance technology in patients with resistant depression and assess healthcare providers' motivation to adopt the technology.

Methods: A retrospective chart review of (N = 73) patients' treatment response measured by the pre-post PHQ-9 depression scale after pharmacogenomic guided medication intervention with descriptive statistics and paired t-test. The …

Development Of A Pediatric Depression Healthcare Toolkit, Maria Theresa Kennedy

Doctor of Nursing Practice (DNP) Projects

Background: Depression is a debilitating and life-threatening disease that strongly affects youth in the United States. Low socioeconomic populations often have high-risk factors for depression, low health literacy, and poor access to care. Risk factors are amplified for those who identify as gender non-binary or lesbian, gay, bisexual, transgender, or queer (LGBTQ). Psychoeducation can empower youth to be active participants within their treatment.

Purpose: The focus of this project was to evaluate a newly developed healthcare toolkit for pediatric depression in the format of an eBook for mental health professionals.

Methods: An eBook focusing on depression pathology, symptoms and …

Fostering Resilience In The School-Aged Child, Patricia D. Schneider

Doctor of Nursing Practice (DNP) Projects

Background: The world is a challenging and sometimes difficult place to navigate. People are faced with tragedies and adversity. Without supportive people and environments, this can lead to poor outcomes such as physically, socially, and emotionally. Children rely on adults to provide safety, love, and security yet many children do not receive the care they need and deserve. Adversity in children affects their development and reduces their capabilities to deal with stress. For a society to prosper and grow, reducing child adversity is essential. Resilience is a powerful tool that can be fostered and developed in children, so they are …