Psychiatry and Psychology Commons^™

Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper

Doctor of Nursing Practice Projects: College of Nursing

Rationale

Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …

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 …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Scholarly Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Police Versus Non-Police Response To 988 Crisis Calls, Miriam A. Maloney-Mattheisen Bsn, Rn, Latrina N. Blakemore Msn, Fnp-Bc, Janelle M. Scullark Msn, Fnp-C, Jacqueline Sharp Dnp, Pmhnp-Bc, Sharon Little Dnp, Fnp-Bc, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

The 988 Suicide & Crisis Lifeline is a mental health-specific emergency line that became nationally available in July of 2022. This resource allows callers in crisis to connect with trained mental health professionals. Despite the initiation of this new dispatching service, there is still a significant shortage of trained mental health professionals to respond to these calls when they require emergency intervention. The present scoping review aims to determine whether non-police crisis responses correlate to improved outcomes when compared to police response as evidenced by reduced inpatient admissions, reduced arrests, and decreased presence of intrusive traumatic symptoms following intervention. …

The Missing Link: The Significance Of Mental Health Screenings Post Natural Disasters: An Integrative Review, Chalita Mccormick Ellis

Doctoral Dissertations and Projects

Following a natural disaster, the emotional and psychological demands on survivors are great. In addition to generating suffering, such as bodily injuries, natural disasters impact disaster victims’ lives in catastrophic ways, causing loss of homes, property, and jobs; food insecurities; transportation disruption; and communication difficulties. These events disrupt communities, exacerbating adversities to physical and psychological well-being. This presents a critical need for effective mental health response. Screening specific to post-disaster trauma may assist in identifying clients who require prioritized mental health care. Depression, anxiety, and posttraumatic stress disorder are three common mental health issues that are often triggered by disasters. …

Medication Errors In Hospitals, Isata Jalloh

Doctoral Dissertations and Projects

In hospitals, the issue of medication errors poses a serious problem, often leading to substantial health complications and, in some cases, even deaths among hospitalized as well as discharged patients. This health challenge not only imposes a substantial financial burden on patients, insurance providers, and Federal/State governments but also contributes to elevated healthcare expenses, hindering the effective allocation of resources to address other healthcare issues. Understanding the triggers of medication errors in hospitals is critical in solving this problem. The purpose of this integrative review is to determine the causes/triggers of medication errors in hospitals. This review will highlight the …

Evidence Synthesis Methodology: Promoting Reproducible Methodology Through Modified Assignments, Laura Lipke, Neyda Gilman

Library Created Resources

Initially, systematic reviews in healthcare served to synthesize findings from clinical studies, aiding comprehensive access to the most effective treatments within evidence-based practice. Over time, their scope has broadened beyond treatment effectiveness, leading to a surge in publication. Consequently, many health science faculty now assign systematic reviews in classrooms without a full grasp of the standardized process, leaving students ill-equipped due to insufficient guidance and resources.

While mastering systematic review techniques is crucial for evidence-based practice, faculty can opt for modified assignments to foster a deeper understanding of the review process. These modified tasks, can be completed within a semester, …

Increasing Medication Adherence In Patients With Bipolar Disorder Using Mobile App Reminder, Emmaculate Ndifor

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Bipolar disorder (BD) is the fifth leading course of disability in the world, contributing to many co-morbid conditions and complications. Non-adherence to medication is prevalent in patients with BD. The aim of the project was to use an evidence-based technological intervention to enhance medication adherence in BD patients between 18- 65 years old at an outpatient behavioral health clinic.

Methods: Baseline assessment included a pre Morisky Medication Adherence (MMAS-4) questionnaire. The development of an intervention to improve medication adherence was based on Johnson’s (2002) Medication Adherence Model (MAM).

Interventions: Participants downloaded the Medisafe app, registered medications and set …

Moral Distress In Critical Care Nursing: A Literature Review, Anna Tindell

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Moral distress is a pressing concern in the healthcare field with significant implications for all areas of nursing and patient outcomes. However, those within the specialty of critical care nursing experience moral distress more frequently than those in other specialties. It arises from the complex ethical dilemmas nurses in critical intensive care units face as they work in these high-pressure environments. The purpose of this literature review is to discuss moral distress in critical care nursing and how it affects a nurse’s ability to provide quality care. Furthermore, this review will determine factors contributing to moral distress and potential interventions …

Anxiety Screening At A Psychiatric Inpatient Facility: A Quality Improvement Project, Irene Akwitti

Doctor of Nursing Practice

Background. Generalized anxiety disorder is characterized by persistent anxiety and uncontrollable worry occurring more days than not for a minimum of 6 months (Patriquin & Mathew, 2017). Presently, anxiety screening and evidence-based practice treatment for adults are suboptimal. It is impossible to overemphasize the importance of early diagnosis and prompt treatment of generalized anxiety disorder in patients. Purpose. The purpose of this quality improvement project was to implement the Generalized Anxiety Disorder-7 (GAD-7) screening tool, a validated, evidence-based instrument, in a psychiatric inpatient facility to improve early detection and treatment of anxiety disorders in patients. Methods. Staff members were educated …

A Quality Improvement Project To Screen For Food Insecurity In Adults With Anxiety Or Depression, Kelsie Evelyn Kroll

Doctor of Nursing Practice

Background Food insecurity is the limited availability and inconsistent accessibility of healthy foods (Coleman-Jensen et al., 2022a). Food insecurity contributes to mental health problems. Individuals with food insecurity have greater odds of screening positive for depression and anxiety (Wolfson et al., 2021). The Hunger Vital Sign™ screening tool is a 2-questions evidence-based tool used to identify food insecurity (Hager et al., 2010). Purpose. Implement the Hunger Vital Sign™ tool at a non-profit behavior health clinic to identify food insecurity in adults who screened positive for anxiety or depression, offer resources for them to obtain nutritious food, and provide additional information …

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …

Body Dysmorphia Screening Tool For Aesthetic Treatments, Brandi Harper

MSN Capstone Projects

This evidence-based project includes a discussion of Body Dysmorphic Disorder (BDD) or body image disturbance as part of pre-treatment screening in medical facilities providing appearance-altering procedures and aesthetic treatments to adult patients. The information provided serves as the foundation for endorsing the adoption of a BDD screening tool into clinical practice to increase the identification of body dysmorphia, thereby facilitating proper referral, diagnosis, and treatment to aid in patient safety and satisfaction and limit medico-legal imputations. The discussion presented here is supported by evidence-based research. It focuses on BDD prevalence and significance amongst adult patients and highlights validated screening tools …

The Addition Of Nature To The Patient's Healing Regimen, Katelyn Lewis, Audrey Henry

Scholars Week

Through our scholarly research, we have found many benefits to the use of nature to help facilitate healing within patients. Our project aims to spread awareness of the positive aspects of nature during the healing process. Specifically, our research focuses on healing gardens and outside therapy for patients. Our presentation is based upon Nightingales' theory of the environment. Our hope is that facilities will implement the addition of nature to the patient's plan of care.

Studying The Impact Of Hyperlipidemia Monitoring Tools On Referral Rates In Patients Taking Antipsychotics, Jasmyn S. Allen

Doctoral Projects

The purpose of this DNP project is to determine how well an evaluation tool may be used to track hyperlipidemia in patients using antipsychotic medicines who are between the ages of 20 and 50. Elevated lipid contents in the bloodstream, or hyperlipidemia, increase the danger of heart-related illnesses. Antipsychotic drugs, frequently administered for mental health disorders and dyslipidemia, have been connected. The goal is to ascertain whether utilizing an evaluation tool raises the three-month referral rates for hyperlipidemia to primary care (Dayabandara et al., 2017). The foundation of the research is found in several articles collected from different websites. According …

Relational Variables Impacting The Healthcare Team, Linda J. Macdougall Ms

Electronic Thesis and Dissertation Repository

The movement in the healthcare system towards interprofessional collaborative teamwork values the perspectives of various healthcare professionals. Although this system shift has been essential to quality improvement, there have been indications of issues occurring between professionals that include conflict and impaired team performance. Although the current literature on interprofessional collaboration acknowledges the competencies and demonstrated behaviours that indicate successful and difficult collaborative efforts there is a lack of research investigating the relational variables that occur between healthcare professionals.

The purpose of this research was to test a theoretically derived model of healthcare professionals’ relational variables. These variables related to warmth, …

Mental Health Problems Among Elementary School Students Mandated To E-Learning: A Covid-19 Rapid Review Caveat, Renée M. D'Amore, Angelina N. Halpern, Lauren R. Reed, Kevin M. Gorey

International Journal of School Social Work

Extended lockdowns during the COVID-19 pandemic mandated millions of students worldwide to e-learning and by default made many of their parents proxy homeschool teachers. Preliminary anecdotal, journalistic and qualitative evidence suggested that elementary school children and their parents were probably most vulnerable to this stressor and most likely to experience mental health problems because of it. We responded with a rapid review of 15 online surveys to estimate the magnitude of such risks and their predictors between 2020 and 2021. The pooled relative risk of mental health problems among school children and their parents was substantial (RR = 1.97). Moreover, …

Self-Care Practices In Doctoral Nursing Students And Effects On Educational Experience, Megan Lutman

Dissertations

Problem: Doctoral nursing students are often faced with stressors on top of their schooling, one of which is continuing to work while pursuing their education. This in combination with normal life stressors can be challenging. The purpose of this project was to survey doctoral nursing students on what their current self-care practices.

Methods: An exploratory needs assessment project was created to gather data from Doctor of Nursing practice (DNP) and Doctor of Philosophy (PhD) nursing students in an urban, mid-sized, Midwestern, public university to identify current self-care practices, barriers to self-care, preference of self-care practices, and the impact these …

Acute Agitation Intervention Tool For Reduction Of Polypharmacy, Brooks J. Propst

Dissertations

Introduction: Patients with behavioral health diagnoses are among the highest risk for
aggression. For pediatric patients with behavioral health needs, urgent treatment is
needed for aggressive behavior, due to the potential unwanted outcomes. The purpose of this Quality Improvement (QI) pilot project was to implement an Acute Agitation Intervention Tool that uses the Broset Violence Checklist (BVC) to guide
pharmacological intervention for mild and moderate to severe agitation in pediatric
patients with behavioral health needs ages 8 to 18 to decrease the number of medications that patients are getting per agitation event over a 12-week period.

Methods: This QI included …

Implementation Of The Columbia-Suicide Severity Rating Scale At An Outpatient Mental Health Practice To Increase Provider Confidence In Identifying Suicide Risk, Lauren Reed

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to implement the Columbia-Suicide Severity Rating Scale (C-SSRS) as part of routine patient assessment at an outpatient mental health practice to increase the likelihood of identifying clients at risk for suicidal behavior and increase provider confidence in screening for suicidal behavior. The study site is a Southern California-based outpatient mental health practice that employs a variety of clinicians, including psychiatric-mental health nurse practitioners, to provide mental health care to clients across the lifespan.

Background: Approximately 57% of individuals who die by suicide had at least one contact with …

Exercise As A Prescription For Patients With Depressive Disorders: A Quality Improvement Project, Sydney Roscoe, Rachelle Pace

Doctor of Nursing Practice Final Manuscripts

Purpose: The aim of this Doctor of Nursing Practice project was to increase exercise counseling rates in the treatment of depression by (1) implementing a focused educational training program and (2) understanding factors that impacted utilization of the practice change.

Background: Approximately 280 million individuals suffer globally from depressive disorders. Depression remains the fourth leading cause of disabilities, significantly contributing toward the global burden of disease by increasing morbidity and mortality risk. Psychopharmacology and psychotherapy are current gold standards of treatment; however, providers often overlook the significant role exercise serves in reducing depressive symptoms and severity, as it remains underutilized. …

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

Therapeutic Gardening For Addiction Recovery, Hugo A. Rivera Lopez

Master's Projects and Capstones

Problem: The use of evidence-based alternative forms of therapy like horticulture therapy and therapeutic gardening is underutilized in substance use recovery programs in the United States. As the country continues to struggle with addiction, it is important that recovery programs look to and incorporate these alternative therapies into official curricula. Currently, 46.3 million individuals living in the United States are living with a substance use disorder (U.S Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, 2022).

Context: The intervention was implemented at an all-male substance use treatment facility in San Jose, CA that houses up …

Therapeutic Gardening For Addiction Recovery, Hayley Milleson

Master's Projects and Capstones

The following study examines the potential benefits of implementing therapeutic gardening and outdoor activities as a supplemental resource for adult males with a history of substance abuse issues who have been affected by the criminal justice system and are seeking sobriety while in a residential treatment program. The goal is to investigate how therapeutic gardening can add to traditional addiction treatment methods. Through a review of current evidence-based practice, this study focuses on how alternative interventions such as therapeutic gardening and outdoor activity can improve overall mental health and well-being, promote a sense of community, improve social connections, alleviate stress …

A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is a debilitating psychological condition that affects 3.1% of the American population and is one of the leading causes of disability (Anxiety and Depression Association of America, 2022; Baxter, 2014). The purpose of this evidence-based practice project was to implement a multimodal intervention to decrease GAD symptoms in adults in the primary care setting. The PICOT question that guided this project was: In adults, over the age of 18, who have been diagnosed with generalized anxiety disorder (GAD), does the combination of digital cognitive behavioral therapy (CBT) through a smartphone application, lifestyle modification education, and pharmacotherapy …

Improving Depression Remission Screening Compliance, Crystal Wingerter

Doctor of Nursing Practice Projects

Depressive disorders are widespread in the United States and are diagnosed and treated in the primary care setting. In 2019, there were an estimated 19.4 million adults that had at least one major depressive episode. The purpose of this project was to improve follow up and depression remission assessment for patients with a diagnosis of depression at a metropolitan family care practice clinic. The Patient Health Questionnaire (PHQ–9) was utilized for remission assessment. Front desk staff and providers were trained and granted access to the quality information system (QIS) in the electronic medical records (EMR) system which allowed easy identification …

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

Impact Of Personalized Interactive Storytelling On Suspension Of Disbelief In Clinical Simulation, Audra Renee-Smith Xenakis

Electronic Theses and Dissertations

The literature review found suspension of disbelief (SOD) in clinical simulation heavily weighted on educators alone within high-fidelity environments. The project examined a co-created narrative background story applied to a simulated patient’s clinical profile to determine achieving an improved connectedness toward the simulated patient leading to enhanced SOD and enhanced levels of learning and reaction. The studied population was third-semester associate degree nursing students over 18 years of age with prior clinical simulation experience who were not repeating the semester. The research methodology used a quantitative experimental design with cluster sampling, randomization, and post-Likert-scored questionnaires. The intervention group co-created personalized …

The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey

Doctor of Nursing Practice Scholarly Projects

Individuals with mental illness are occasionally hospitalized on medical units, specifically medical-surgical units. Nurses working on medical-surgical units may find patients with mental illness more challenging due to the complexity of care they sometimes require. Nurses’ perceived ability to provide quality care for these patients is reduced in comparison to their perceived ability to care for patients without mental illness. Consequently, low self-efficacy can result in the provision of a lower quality of care for this population. The purpose of this quality improvement project was to improve the care that patients with mental illness receive while hospitalized on medical-surgical units. …

Social Media Addiction Among Nursing Students And Its Related Factors, Akgün Yeşiltepe, Bedriye Cansu Demirkiran, Sevgi Demir Çam

Makara Journal of Health Research

Background: Social media use has become an indispensable part of our lives as a result of technology advancement and is quite high among students.

Methods: This study employed a cross-sectional design. Participants were 289 students from the Faculty of Health Sciences at Artvin Coruh University, Turkey. The Social Media Addiction Scale (SMAS) was used to obtain data. T-test, one-way ANOVA, Pearson’s correlation, and Bonferroni analysis were used to analyze the data.

Results: The participants’ mean SMAS score was 81.03 ± 34.79, which was moderate. A weak and positive correlation was found between social media addiction and daily …