Mental and Social Health Commons^™

Outcomes Of Directly Observed Therapy In People Living With Hiv Who Experience Homelessness And Substance Use Disorder, Mara C. Clawson

Doctor of Nursing Practice (DNP) Projects

Background: Antiretroviral directly observed therapy, in which nurses or other allied health professionals provide patients with daily medication, is an evidence-based solution for viral load suppression in people living with HIV who experience homelessness. Purpose: This quality improvement project aimed to assess the outcomes of antiretroviral directly observed therapy at one urban clinic caring for people living with human immunodeficiency virus who experience homelessness and substance use disorder. Methods: Data was collected from the electronic health record for the antiretroviral directly observed therapy patient cohort (n = 33); 10 of them were surveyed. Fisher exact tests determined nonrandom associations between …

Standardizing Behavioral Health Triage: Using The Heads-Ed Tool, Sarah K. Peifer

Doctor of Nursing Practice (DNP) Projects

Background: In the past two years emergency departments across the country have experienced an increase in pediatric patients requiring behavioral health care. It is essential to provide efficient, early intervention to these vulnerable patients. The use of a standardized tool can improve management of pediatric patients and allow access to resources in a timely manner.

Purpose: To evaluate the implementation of the HEADS-ED in a community hospital ED, to provide rapid behavioral health assessment.

Methods: Education for staff was provided through various platforms and involved regular support for staff throughout the intervention. It was hypothesized that implementation of …

School-Based Telemental Health And Family Psychoeducation: A Program Evaluation, Ainat Koren

Doctor of Nursing Practice (DNP) Projects

Background: Telemental Health has been established as an effective model of care in the adult population. There are few studies that addressed the effects of providing child and parent telehealth services in underserved communities where mental health services are sparse. Families who attend face to face mental health support report high levels of satisfaction, show increased knowledge about mental illness/treatment, and youth have a lower risk of relapse.

Purpose: The purpose of this DNP project was to evaluate an innovative Telemental Health model offering timely social/behavioral health support for children/families’ mental health services in rural Massachusetts.

Methods: Process …

Adolescent Mental Health Training For Middle School Educators, Sarah Minton

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Adolescent mental health disorders are an increasing concern in the United States. School systems, specifically educators, are in the unique role to aid in early identification of mental health disorders, as well to intervene in mental health distress. However, mental health training for educators is lacking, leaving educators unprepared to manage mental health concerns within their classroom.

Purpose: The purpose was to utilize an evidence-based training, the “Teacher Knowledge Update Guide” from TeenMentalHealth.org to train middle school educators on the signs and symptoms of mental health conditions in the adolescent population with the intent to increase awareness, knowledge, …

The Impact Of Ptsd And History Of Involvement In The Criminal Justice System On Medication Treatment Success In Opioid Use Disorder, Kirk Sanger

Doctoral Dissertations

This analysis examined the impact of post-traumatic stress disorder (PTSD), history of trauma, and a history of involvement in the criminal justice system (CJS) on treatment outcomes related to medication treatment for opioid use disorder. This study employed a secondary analysis of data derived from a multi-state, multi-site treatment center focused on substance abuse and more specifically opioid use disorder treatment. The total sample size was 19,970 patients. The majority of the sample received treatment in Massachusetts, was white, and non-Hispanic. Those with PTSD accounted for 9.5% of the sample, while 12% had a history of trauma. Just under 1/4 …

Increasing Staff Knowledge And Screening Practices For Adverse Childhood Experiences In Primary Care, Angela Mcgraw

Doctor of Nursing Practice (DNP) Projects

Adverse childhood experiences (ACE) are important to future health outcomes. Many health care providers lack the knowledge or training to assess for ACE. Purpose. The purpose of this quality improvement project is to increase the identification of ACE among adult clients in a primary care clinic in Saint John New Brunswick Canada, through the delivery of an education session for the health care team members and patient screening for ACE. Methods. Staff at one clinic attended an educational program about ACE. Staff completed a pre and post education survey questionnaire (N = 8). Additionally, clinic patients (N= 32) were screened …

Using Cognitive Behavioral Therapy To Treat Insomnia In Adults, Alexandra Christodoulou

Doctor of Nursing Practice (DNP) Projects

Background: Insomnia is a physically, mentally, and psychologically complicated and distressing medical condition that can affect adults with or without comorbid conditions. Research indicates that cognitive behavioral therapy (CBT) is an underutilized, but extremely beneficial intervention that may support individuals in overcoming insomnia and other comorbid conditions, without ever ingesting a pill. Unfortunately, CBT is underutilized due to the patient educational time requirements; therefore, medication is often prescribed as a first line of treatment for insomnia. Adults suffering from insomnia with or without comorbid conditions such as psychiatric disorders or cancer have benefitted from CBT as opposed to oral …

A Quality Improvement Project For Co-Occurring Disorders In Outpatient Behavioral Health, Erin Sheehan

Doctor of Nursing Practice (DNP) Projects

Purpose: Patients with mental health diagnoses often have co-occurring alcohol use disorders, which can exacerbate their psychiatric symptoms. A standardized assessment tool should be utilized for screening for alcohol use disorders in outpatient mental health programs so that interventions can be implemented when a co-occurring disorder is identified. The purpose of this project was to provide clinicians with education and to improve the process for screening patients with mental health disorders for problematic drinking behaviors to implement recommended interventions when appropriate to improve the overall quality of the patient’s care and increase the clinician’s knowledge and confidence in treating co-occurring …

Development And Evaluation Of An Emergency Department-Based Nurse Practitioner Care Delivery Model, Tiesha Johnson

Doctor of Nursing Practice (DNP) Projects

Background: Acute mental health care needs are not always optimally managed in the Emergency Department (ED) with the traditional approach to care and management. The ED encounter for psychiatric patients is lengthy, costly, fragmented, inefficient and often ineffective, contributing to poor outcomes.. Purpose: To introduce the evidence- based advanced nursing practice model to ED professionals and staff for feedback and evaluation of an ED-based Psychiatric Nurse Practitioner care delivery model for the acute care of psychiatric patients. Implementation: The care delivery model was created based on evidence and presented to professionals and staff at one medical center ED. A focus …

Implementation Barriers Of The Phq-9 In Primary Care: A Quality Improvement Project, Angela P. Miller

Doctor of Nursing Practice (DNP) Projects

Purpose: The purpose of this research translation project was to mitigate the consequences of under-recognition, and under-treatment of depression through use of an evidence-based depression-screening tool, the PHQ-9, in a primary care setting.

Methods: A plan-do-study-act model was utilized for the implementation of this initiative. An informal educational intervention about administration and interpretation of the PHQ-9 first took place at the provider level in a primary care practice. Next, a pre and post-test study design (n=12) was administered to providers, nursing, and ancillary staff. A report was shared at monthly quality meetings with representatives from each practice in the health …

Injection Drug Users’ Perceptions Of Received Nursing Care: A Case Study, Kimberly Dion

Doctoral Dissertations

The primary aim of the exploratory case study was to explore the injection drug users’ experience with received nursing care while hospitalized on a medical unit. Data were gathered using semistructured interviews with nine injection drug users at two needle exchange services. Five men and four women were interviewed for 27–90 minutes. Travelbee’s (1971) interpersonal nursing model served as the theoretic framework for this study. Data were analyzed through the process of coding, pattern matching, and the convergence of emerging themes. For the rival case, the theme of Understanding Addiction emerged. For the comparison cases, the overarching themes of Marginalization …