Medicine and Health Sciences Commons^™

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 …

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 …

Effects Of Nurse-Patient Relationship On Mental Health Patients’ Medication Adherence/Healthcare Outcome, April Monica Magbual

Nursing | Senior Theses

Background and Significance: Medication adherence among mentally ill patients (MIP) is a significant issue which require extra support & guidance to encourage better recovery. Administering medication is a critical role of nurses that must be performed effectively and appropriately, especially for MIPs.

Literature Review and Gap in the Literature: There is insufficient research exploring NPR and medication adherence specifically for MIPs. Participants’ cultural variations, age range, specific interventions & economic factors influencing medication compliance are missing. The current study aims to explore strategies that nurses can implement during patient interaction in the hospital setting.

Study Design and Method: A qualitative …

The Effect Of Transfer Of Care Protocol On The Rehospitalization Rates In Psychiatric Patients, Fernando Guillen Msn, Cnp, Pmhnp-Bc

Student Scholarly Projects

Practice Problem: The problem involved the transition of psychiatric care from long psychiatric hospitalizations to community-based psychiatric treatment which has developed into shorter inpatient psychiatric hospitalizations, which in turn has developed into a significantly higher number of individuals being readmitted within one year of inpatient discharge.

PICOT: In adult patients undergoing inpatient acute psychiatric care (P), how does the use of a transfer of care protocol (I), compared to current transfer of care practice (C), affect the rate of readmission within 30 days for inpatient acute psychiatric care (O), in 10 weeks?

Evidence: The evidence from an extensive literature review …

Treatment Pearls: Management Of Physical Healthcare Needs In Patients With Mental Illness, Leslie W. Miles, Brandon Thatcher, Michael C. Thomas, Blaine Winters

Faculty Publications

Clinicians caring for persons with mental illness should be aware of increased mortality, physical problems, and health disparities in this population. This article provides a brief overview of physical health problems in the context of mental illness as well as those related to psychotropic medications, and discusses strategies to manage treatment effectively.

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 …

Effectiveness Of A Web-Based Smoking Cessation Training Program For Health Care Professionals Within An Acute Psychiatric Facility, Allie Carmichael

DNP Projects

Background: Tobacco use is the leading preventable cause of death and disease in the United States, with the prevalence remaining especially high among people with mental illness. Mental health providers often lack training in smoking cessation and feel uncomfortable addressing the issue with this patient population. Studies show that educational training offered to providers can lead to increased knowledge that improves the provider’s confidence and attitude about delivering smoking cessation treatment to patients. Mental health professionals must receive training on smoking cessation treatment modalities so they can effectively provide holistic care needed for recovery for patients with mental illness.

Purpose …

Themes And Associations Concerning The Covid-19 Pandemic: Autoethnography, Amber Mcgannon, Ebunoluwa O. Adedeji

Williams Honors College, Honors Research Projects

Per the college of nursing, my proposed project will discuss living during uncertain times and unusual times of change. This APA formatted paper will be an autoethnography, meaning that we will review the perspectives of COVID through the lens of culture, research, and our own perspectives and experiences. Everyone has experienced changes during the COVID-19 pandemic due to self-isolation. Examples of change include changes in learning, working, thinking, teaching, and behaving. Using acquired nursing skills such as critical thinking, reflection, inquiry, and evidenced-based practice; my partner and I will dissect and discuss these changes and how they have affected ourselves, …

Providing Resources To Caregivers Of Pediatric Mentally Ill Clients And Assessing For Caregiver Burden, Stacy Dee

Doctor of Nursing Practice

Background. Provision of educational and supportive resources to the caregivers of children with mental illness can help create an environment of advocacy and understanding between the child, caregiver, and provider. In depth and comprehensive learning about their child’s mental illness cannot be accomplished in a one-hour new patient appointment or established patient appointment of 20 minutes. Purpose. The purpose of this practice improvement project was to facilitate educational and community support for caregivers of pediatric clients with mental illness and evaluate if caregivers require additional support due to burden. Objectives. (a) 100% of caregivers of pediatric clients who have appointments …

Effectiveness Of Video-Assisted Teaching On Awareness (Knowledge And Attitude) Towards Mental Illness Among Public, Vinisha Almeida, Nanda Kumar Paniyadi, Asha K. Nayak

Manipal Journal of Nursing and Health Sciences

Introduction: Knowledge and attitude of mental illness affect behaviour tremendously. The attitude of people towards mental health problems are negative, condemned, ignorant, and apprehensive. Objectives: To assess the effectiveness of video-assisted teaching (VAT) on knowledge and attitude of the public towards mental illness. Methods: A quantitative, pre-experimental one-group pre-test post-test design was used among 80 people using a judgmental sampling technique. For data collection, a knowledge questionnaire and an attitude scale were developed. An appropriate VAT was developed that was administered as an intervention. The intervention was done after four weeks and the effectiveness of the program was assessed by …

Minimizing Antipsychotic Medication Side Effects In Adults Diagnosed With Mental Illness Through Psychoeducation: An Evidence-Based Approach, Sarah A. Yao

Doctor of Nursing Practice Projects

Adherence to antipsychotic medication has demonstrated significant impact in decreasing symptom exacerbation among patients diagnosed with mental illness. Antipsychotic medications have several benefits including the management of psychotic and mood disorders; however, they could cause unwanted medication side effects with metabolic and cardiovascular risks. This issue is one of the commonly linked side effects resulting in nonadherence among mentally ill patients. The purpose of this project was to implement a psychoeducational intervention using the SIMPLE program to address metabolic and cardiovascular risks associated with antipsychotic medications among adult patients diagnosed with mental illness. A sample size of sixteen adult patients …

Reducing Gaps In Knowledge About Electroconvulsive Therapy Among Mental Health Nurses, Janice L. Edmonson

Electronic Theses and Dissertations

This DNP study was conducted to identify knowledge gaps about electroconvulsive therapy (ECT) among mental health nurses and to determine the effectiveness of an educational intervention on the knowledge and attitude of mental health nurses about the use of ECT at a psychiatric hospital. In this study, the researcher sought to build upon an existing knowledge base using principles of adult learning theory to enhance the therapeutic relationship of the nursing staff when caring for ECT patients. A sample of three-quarters (N = 119) of the mental health nursing staff employed by the psychiatric hospital consented to participate in …

Mental Health Concerns In African American Churches: Pastoral Preparedness In Counseling, Melody Samuel

Nursing Theses and Capstone Projects

African Americans rely heavily upon their pastors for more than spiritual guidance. Pastors are known as gatekeepers in the African American community serving as a resource to address a multitude of issues for their congregant from personal issues such as finances and marital issues, grief and bereavement, to physical and mental health issues. The aim of this study was to examine pastoral preparedness for counseling of mental health concerns in the African American church. To better understand the demand of mental health counseling for their congregants and assess the pastor’s perception of educational and training needs, 35 pastors and/or associate …

Care For Inmates With Mental Illness: What Can Nurses Do?, Rebecca K. Sakai

Honors Projects

This paper serves to inform nurses of the medical and psychiatric treatment that inmates with mental illness receive and to offer suggestions for treatment interventions. Current practice includes mental health screens, psychotropic medication administration, psychiatric departments, and administrative segregation. The recommended interventions include providing therapy (including Cognitive Behavioral Therapy and Group Therapy), decreasing administrative segregation, implementing reintegration programs, and training and collaborating with correctional officers.

Spiritual Perspectives, Spiritual Care, And Recovery-Oriented Practice In Psychiatric Mental Health Nurses, Melissa Neathery

Nursing Theses and Dissertations

The prevalence of mental illness is well documented with 450 million people suffering with a mental illness worldwide. Nurses are integral to the delivery of mental health services and can influence the provision of individually focused, evidence-based, and culturally competent care. Spiritual care has been shown to enhance coping, improve well-being, and increase satisfaction with care for those in mental health recovery. Three manuscripts presented in this dissertation portfolio explored and addressed the concepts spirituality and spiritual care for those in mental health and substance use recovery. The Recovery Practice Model was examined and how spiritual care can be integrated …

Bsn Students' Opinions Of Mentally Ill Patients, Kavika Chugh

Honors Undergraduate Theses

Compassionate care, or humanism, should be available to all patients, but the stigma associated with mental illness is a barrier to many people receiving the appropriate care. Views held by Bachelor of Science in Nursing (BSN) students can vary from custodial, or the belief in a traditional medical model which involved a highly controlled setting for all mentally ill patients, to humanistic, or viewing the hospital as a therapeutic community for the human needs of a patient. This study examines the views of BSN students before their psychiatric clinical experience through a pretest and post-test survey and analyzes for a …

Treatment Recidivism In Adolescents With Mental Illness: A Focused Applied Medical Ethnography, Chukwudi C. Ekwemalor

Dissertations & Theses (Open Access)

Background

Treatment recidivism, described as frequent unplanned relapse readmissions, is a national problem predominant in adolescents with mental illness with significant socioeconomic consequences. Adolescents living with mental illness are a sub-culture of adolescence, the critical growth period of developmental and social transition from childhood to adulthood. The main triggers of treatment recidivism in this population are not fully understood from previous studies.

Purpose

The study purpose was to explore treatment recidivism with the following aims:

1. To illuminate treatment recidivism from the perspectives of recidivist adolescents with mental illness.

2. To describe the main factors that contribute to treatment recidivism …

Exploring The Mobile Phone Digital Divide Among Individuals Experiencing Mental Illness: A Secondary Analysis, Jefferey R. Reed

Electronic Thesis and Dissertation Repository

ABSTRACT

Aim: To test van Dijk’s (2005) Framework for Understanding the Digital Divide. This framework examines social inequalities that influence the phenomenon of the digital divide and the implications it has upon social participation for individuals with mental illness.

Background: Mental illness is the second leading cause of disability and premature death, and constitutes more than 15% of the burden of disease in Canada (Centre for Addiction and Mental Health, 2012). Mobile phones may be useful in promoting health and social wellness among this population. It is unclear whether these individuals face disparities in the access to and use of …

The Development And Implementation Of Hospital-Based Clinical Guidelines To Enhance Nursing Staff Efficacy In Glycemic Management At A Large Psychiatric Teaching Hospital, Cherno Bah

Doctor of Nursing Practice Projects

Background: This quality improvement project was conducted at the Colorado Mental Health Institute at Pueblo (CMHIP) in order to improve glycemic management. In psychiatric inpatient settings, proper glycemic management is inadequate which increases metabolic risk and poor patient outcomes. One way to address this problem is by using practice guidelines and education, which enhances nurses’ efficacy.

Purpose: The purpose of this project was to develop and implement a glycemic management guideline to enhance clinical nursing staff knowledge and confidence.

Method: Fifty-five clinical nursing staff attended an in-service and were asked to fill out a survey before and after the in-service …

Preventing Reincarceration Of Women With Mental Illness, Anne M. Dolmovich

Honors Undergraduate Theses

Since deinstitutionalization of state hospitals began almost 50 years ago, there has been an increase in the population with mental illness seen in the prison system. A combination of factors were looked at when studying causes behind incarceration, including active symptoms of mental illness, socioeconomic status, social support systems, history of trauma, history of drug abuse, police education on mental illness, and public perspective on mental illness. This study is a literature review focusing on people with mental illness in the prison system, with particular attention to women.

It is costly to house inmates for any extended period of time. …

Effect Of Case Management On Frequency Of Emergency Department Visits By Persons With Mental Illness: A Systematic Review, Allison M. Stanton, Kayla C. Osoteo

Williams Honors College, Honors Research Projects

A problem in healthcare is the increasing number of emergency department visits by repeat users with a comorbid mental illness. These visits increase costs, patient wait times, demand for service, overcrowding, and fragmented care; they may decrease quality of care and effective treatment. The purpose of this study is to identify, review, and critically appraise the evidence about the effect of case management on repeat emergency department (ED) use in those with comorbid mental illness. A systematic review of 21 studies was performed. All explored mental illness, frequent visits to the ED, and interventions. These twenty-one studies were reviewed and …

Association Between Socioeconomic Status And Bmi Among People With Schizophrenia And Bipolar Disorder, Nicholas Guenzel

Theses & Dissertations

Background: Many health disparities among individuals with schizophrenia and bipolar disorder are due to obesity-associated diseases. Several causes of obesity have been discovered, but few risk factors are known. In the general public, low socioeconomic status (SES) is associated with obesity.

Objective: Examine the relationship between SES and body mass index (BMI) among people with schizophrenia and bipolar disorder.

Design: A secondary analysis of the Collaborative Psychiatric Epidemiology Surveys dataset. The psychiatric group (N=480) included individuals with symptoms of schizophrenia or bipolar disorder. Those reporting no symptoms were controls (N=5,161). Childhood SES variables included mother and father education and profession, …

Psychiatric Comorbidities And Bmi: An Exploratory Analysis, Nicholas Guenzel

Theses & Dissertations

Background: Individuals with most forms of mental illness have higher rates of obesity than members of the general public putting them at an increased risk for many physical health problems that reduce both quality of life and life expectancy. The presence of multiple comorbid psychiatric disorders has been associated with poorer clinical outcomes in other mental health measures such as disability and sobriety and is proposed as a risk factor for elevated BMI (body mass index) in this study.

Objective: Determine if multiple psychiatric comorbidities are associated with elevated BMI and, if so, which combinations are linked with the greatest …

Association Between Adverse Events In Childhood And Bmi Among People With Schizophrenia And Bipolar Disorder, Nicholas Guenzel

Theses & Dissertations

Background: People with schizophrenia and bipolar disorder die significantly earlier than members of the general public (16-18 years and 12-13 years, respectively). Diseases associated with obesity such as diabetes, heart disease, and stroke account for much of this discrepancy. People with mental illness often have difficulty losing weight despite intensive interventions. As a result, nurses caring for patients with mental illness need to monitor their weight diligently and implement individualized interventions to promote achieving or maintaining a healthy weight. Because intensive interventions come with some risk and expense, programs must target individuals with the most potential to develop obesity. In …

Circle Of Care And Hope: An Adaptation And Empowerment Mental Health Healing Model For Blacks, Judy Edvaline Vansiea

Theses and Graduate Projects

PURPOSE- To engage and empower Black people with a "Circle of Care and Hope" that helps them to overcome their unequal access to effective mental health treatment. PROJECT DESCRIPTION- Black people in the United States have experienced unequal access to effective mental health care treatment due to centuries of oppression by the dominant Caucasian culture in the United States. This history has caused many Black people to distrust the purely Western and Caucasian-dominated model of mental health treatment. In response to this problem the author has adapted and integrated three healing modalities: multiple Western, theoretically-based therapies; culturally appropriate practices for …

Patient Experience Measurement Ignores Mental Health: Suggestions For Healthcare Organizations, Mona Shattell Phd, Rn, Faan, Andrew Gallan Phd

Mona Shattell

No abstract provided.

Examining Provider Perspectives On Implementation Of An Integrated Primary And Behavioral Health Care Model In The Outpatient Setting: A Qualitative Study, Holly Gray

DNP Projects

AIM The purpose of this qualitative descriptive research study was to identify and describe primary and mental health provider perspectives, including attitudes and knowledge related to integration of primary and behavioral health care in the outpatient setting. One objective of this project was to gather information from providers in both primary and behavioral health settings to ascertain how they perceive the idea of integrated care. Another objective of this project was to gather information about provider perception of current practice protocols for treatment of patients with comorbid physical and mental health issues, perceived facilitators and barriers to integrated care, and …

Beyond Easy Answers: Facing The Entanglements Of Violence And Psychosis, Nev Jones, Mona Shattell Phd, Rn, Faan

Mona Shattell

No abstract provided.

Recommended Actions For Improved Care Transitions: Mental Ilnesses And/Or Substance Use Disorders, Chris Walker, Paul Goering, Cathy Brouwer, Kathy Knight, Karen Lloyd, Terry W. Crowson, Michael A. Trangle, Paul Davis, Jennifer Mcnertney, Sue Abderholden, Nancy Houlton, Kathy Cummings, Joann Foreman

Articles

The transition period between care settings is the most vulnerable time for patients and their caregivers. The unique vulnerabilities for patients with mental illnesses such as depression, mania, anxiety, schizophrenia and/or substance use disorders* heighten the need for coordinated transitions and aftercare. In 2010, depression was the fourth diagnosis by volume for readmissions in Minnesota according to the Potentially Preventable Readmissions data collected by the Minnesota Hospital Association.

Smoking Cessation Among Persons With Co-Occurring Substance Use Disorder And Mental Illness, Chizimuzo T.C. Okoli, Milan Khara

Chizimuzo T.C. Okoli

Aims: A history of either a substance use disorder (SUD) or psychiatric disorder (PD) is associated with tobacco use. However, there is limited information available on tobacco dependence treatment outcomes among individuals with co-occurring SUD and PD. Methods: Data from 202 participants enrolled in a tobacco dependence treatment program in an outpatient clinic setting were analysed. Findings: In multivariate analysis, having a history of SUD only (OR =.11, 95% CI = .02–.76) and having a co-occurring SUD and PD (OR = .13, 95% CI = .02–.81), as compared to having neither, were significant predictors of a lower likelihood of achieving …