Mental and Social Health Commons^™

Implementation Of A Shared-Decision Making (Sdm) Approach In A Community Based Outpatient Mental Health Clinic, Alexa Vuylsteke

Doctor of Nursing Practice Final Manuscripts

Purposes/Aims: The purpose of this Doctor of Nursing Practice (DNP) project is to implement an evidence-based SDM approach in a culturally diverse community mental health clinic in order to increase patient-provider collaboration and improve patient autonomy and engagement in decision making processes of care in a mental health setting.

Rationale/Background: According to the Substance Abuse and Mental Health Services Administration (SAMHSA), shared decision-making (SDM) is a collaborative communication approach between patient and provider that aims to help people in treatment work together to have informed, meaningful discussions about their health care decisions. SDM is an evidence-based approach to encourage and …

Implementation Of Clinical Institute Withdrawal Assessment: Alcohol Revised (Ciwa-Ar) Education Program In A Crisis Stabilization Unit, Amanda Dehart

Doctor of Nursing Practice Final Manuscripts

Background: At this time the crisis stabilization Units do not currently utilize the Clinical Institute Withdrawal Assessment: Alcohol Revised tool with patients who may experience Alcohol Withdrawal Syndrome. Patients with alcohol use disorders have a high comorbidity rate with psychiatric disorders (Butterfield, et al, 2020). The Clinical Institute Withdrawal Assessment: Alcohol Revised or CIWA-Ar is currently the most widely used assessment tool in the psychiatric setting when assessing patients who may be experiencing Alcohol Withdrawal Syndrome (Pribék, et al, 2021) .

Purpose of Project: The purpose of this project is to measure pre and post -education knowledge of the registered …

Mantram For Mamas: A Pilot Study For Postpartum Women, Ritamarie Smedile

Dissertations

Objective: This pilot study launched an online Mantram Repetition Program (oMRP) using a virtual health portal that aimed to explore online portal accessibility, oMRP acceptance, and overall interface satisfaction among a sample of postpartum women.

Background: Postpartum depression remains one of the most common and severe childbirth complications, affecting more than 13% of women during the first three months after childbirth. Cognitive or behavioral talk therapy sessions and medication are the most frequently recommended treatments to alleviate symptoms. Although effective, women tend not to enroll or adhere to these modalities, suggesting they need alternative treatment plans. A possible alternative, mirroring …

Anxiety And Agitation In Adult Patients Admitted To An Emergency Room During The Covid-19 Pandemic, Doris L. Asombrado

Dissertations

Purpose: The purpose of this retrospective correlational study was to identify the relationship between COVID-19 status and the prevalence of anxiety-agitation with select sociodemographic and clinical characteristics in adults admitted to the ED during the pandemic (03/01/2020 through 12/31/2020).

Background: COVID-19 infections combined with the WHO and CDC recommendations to mitigate spread have had deleterious psychosocial and economic outcomes with the risk of subsequent COVID-19 related mental illness. Studies indicate one in three adults experience anxiety or depression.

Methods: This retrospective correlational study reviewed 2,572 psychiatric admissions from a Southern California ED during the pandemic from March 1, 2020 through …

Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb

Master's Projects and Capstones

In a world that demands the constant requirement of adaptability and technology, the need for ‘hands on the ground’ continues to persist, and perhaps even grow. This research project explores burnout in the healthcare and nonprofit settings, as a pre-existing and ongoing issue, that was brought to centre-stage during the Covid-19 pandemic. The researcher explores the intersections of burnout with workplace culture, person-centered care (PCC), sweat equity and duty-of-care, through expert interviews and literature reviews. Data collected provides an immediate understanding of current workplace cultures and environments for human service providers, in both healthcare and nonprofit sectors. While the data …

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 Mental Health In Substance Use Recovery, Stephanie E. Schafer

Master's Projects and Capstones

Abstract

As the clinical nurse leader (CNL) in this project, I used the “[CNL]

Essential 1: Background for Practice from Sciences and Humanities” (Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice, 2013) and its competencies to focus on designing nursing care for a clinical or community-focused population based on biopsychosocial, public health, nursing, and organizational sciences and to synthesize evidence for practice to determine appropriate application of interventions across diverse populations. With the help of the CNL competencies and collaboration with the healthcare team, we created and implemented a therapeutic garden for residents in a substance use …

Mental Health Navigators Bridging The Gap Of Care, Valentina Loreto-Ashley

DNP Qualifying Manuscripts

Individuals with schizophrenia are most vulnerable at time of discharge due to risk factors that lead to relapse, re-admission, suicide and/or danger to others. A successful discharge process can decrease overall care costs, promotes team collaboration, supports the therapeutic relationship between client and care provider, and helps the client to reach autonomy and self-efficacy. This DNP is a quality improvement project that aims at educating Mental Health Navigators about symptoms of schizophrenia, medications management, and community resources. Effectiveness of the educational intervention will be assessed as the differences between the pre- and post-test assessment score on insight or lack of …

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 …

Second-Victimhood Among Anesthesia Providers & The Effects On Patient Outcomes, Erika Aitken

Doctor of Nursing Practice Projects

Anesthesia providers work in environments promoting productivity with tremendous pressure to begin the next case regardless of any recent adverse events that may have occurred (Wands, 2021). Certified nurse anesthesiologists (CRNAs) potentially struggle with a lack of recognition, a high number of hours, inadequate work-life balance, and limited professional advancement, which all contribute to high stress levels within the field (Andrade & Dantas, 2015). A healthcare professional involved in an unexpected adverse event, medical error, or patient-related injury is labeled as a second victim. Thirty anesthesia providers from a central Illinois hospital viewed a PowerPoint presentation, completed a survey, and …

Meditation-Type Exercise For The Management Of Chemotherapy Related Cognitive Impairment In Breast Cancer Patients, Christine Cain

Evidence-Based Practice Project Reports

Chemotherapy-related cognitive impairment (CRCI), or “chemobrain”, is one of the most troublesome side effects of chemotherapy (Dijkshoorn et al., 2020). Ongoing CRCI may negatively affect relationships, confidence, sleep, fatigue, anxiety, and the ability to return to work activities leading to a decreased quality of life (Johns et al., 2016; Gokal et al., 2018). The purpose of this evidence-based practice (EBP) project was to assess the efficiency of a meditation-type exercise intervention, chair yoga, on decreasing perceived cognitive impairment (PCI) in breast cancer patients. The PICOT question for this project was: In breast cancer patients with chemotherapy related cognitive impairment (P), …

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 …

Psychometric Evaluation Of Phq–9 And Gad–7 Among Community Health Volunteers And Nurses/Midwives In Kenya Following A Nation-Wide Telephonic Survey, Sabina Odero, Paul Mwangi, Rachel Odhiambo, Brenda Nzioka, Constance Shumba, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Nurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya.

Methods: Between June and November 2021, a national survey on mental well-being …

Naloxone Education To Improve Distribution In Primary Care: A Quality Improvement Project, Joanna Boback

DNP Projects

Significance and Background: Opioid overdose is a major public health problem in the United States. The Centers for Disease Control and Prevention (CDC) developed guidelines for prescribing opioids which have not been widely integrated into practice. These guidelines specify co-prescribing naloxone with opioids as a form of harm reduction. A policy to reflect these recommendations was needed to guide prescribing at a Federally Qualified Health Center (FQHC) in Connecticut to increase low naloxone prescribing rates. Evidence supported the use of provider education to increase prescribing rates.

Purpose: Deliver education to providers across the health system on best practices related to …

Tiny Tusk Internship: Barriers To Effective Breastfeeding Within Low Socioeconomic Populations, Catherine Johnson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusk Breastfeeding and Infant Support is a program created to facilitate safe and quiet places for mothers to breastfeed at various events at the University of Arkansas. It serves as a platform to spread important and essential information about breastfeeding to mothers and reach various women all from different backgrounds and populations. The purpose of this review of literature is to identify barriers that women within low socioeconomic populations face that influence their decision to breastfeed. These barriers included lack of social support from family, friends, and healthcare providers; latch difficulty; and concerns of milk supply. Altogether, low-income women …

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. …

Suicide Screening Among Adolescents With A History Of Mental Or Physical Abuse- Evaluating The Effectiveness Of Suicide Screening: A Scoping Review, Tiffany Nicole Jackson Bsn, Rn, Cody Tyler Cottrell Bsn, Rn, Allison Tucker Mcculley Bsn, Rn, Cen, Sharon Little Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this scoping review is to gather evidence on best practice for the administration of pediatric suicide screening in a variety of healthcare settings.

Wellness Review 2022, Part 2, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: Similar to prior reviews, the Journal of Wellness editors searched the literature from the second half of 2022 for an interesting and impactful selection of publications on wellness in healthcare professionals.

Methods: Editors conducted a standard keyword search in Pubmed, focusing chiefly on large journals, interventional trials, and other prospective research. We included papers published between July 1, 2022 and December 31, 2022.

Literature in Review: Finding several hundred publications, we excluded editorials, reviews, and some smaller, less generalizable papers. A final 25 significant studies focusing on wellness in medical professionals were sorted into the following categories: logistics, creativity …

The Utilization Of Depression Screening Tools In Patients With Diabetes Type 2, Hanna Book, Kennedy Eldridge, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Artangela Henry Dnp, Agacnp-Bc, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Diabetes and depression are highly prevalent and concerning conditions impacting millions worldwide. Evidence-based guidelines recommend regular depression screening of individuals with type II diabetes (DM2) to appropriately diagnose and treat depression and proactively enhance clinical outcomes. The gold standard for determining depression in patients with chronic disease is the diagnostic clinical interview; however, many clinicians have turned to brief, self-reported screening tools such as the PHQ-2 and the PHQ-9 whose use are recommended by evidence-based guidelines. This study aims to assess the utilization of the PHQ-2 and PHQ-9 versus no screening on DM2 patients in a primary care setting. …

Prevention And Education In Medication Assisted Treatment Facilities, Lindsey Mccartt

Epsilon Sigma at-Large Research Conference

Introduction and Background: Between 1999 and 2014 the number of patients in the labor and delivery that were on medication for opioid use disorder (MOUD) quadrupled. The rate of unintended pregnancies in pregnant patients of mOUD is at a tremendous high due to inconsistencies in the use of reliable contraception in this population.

Purpose Statement: To reduce the number of unintended pregnancies and infants born with neonatal abstinence syndrome there is a need for prevention and required education for men and women in medication-assisted facilities.

Literature Review: Twenty research studies were reviewed and evaluated. These articles were …

Benefits Of Rooming-In On Infants With Neonatal Opioid Withdrawal Syndrome, Emma Ricioli

Nursing | Student Research Posters

Neonatal opioid withdrawal syndrome (NOWS) is a significant public health concern, affecting infants born to mothers who use opioids during pregnancy. Those exposed in-utero exhibit numerous signs of withdrawal after delivery including tremors, gastrointestinal distress, inconsolability, and poor feeding. Typical treatment for infants suffering from NOWS included direct admission to the neonatal intensive care unit (NICU) for close observation and pharmacological interventions. However, NICU stays can interfere with bonding and breastfeeding. They can also lead to increased lengths of stay, higher costs, and more invasive pharmacological treatments. These infants typically do not have any other concerning health issues besides NOWS …

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

Nursing | Student Research Posters

Medication adherence among mentally ill patients (MIP) is a significant issue in healthcare which require extra support & guidance to encourage better recovery. Administering medication is a critical role of nurses that must be performed effectively and appropriately. Employing a nurse-patient relationship (NPR) and nursing presence has been shown to create a positive outcome and an essential characteristic to improve medication adherence. However, 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.

Post-Traumatic Stress Disorder Among Healthcare Professionals Working In Emergency Transport And Critical Care Settings, Keenan Mai

Nursing | Student Research Posters

No abstract provided.

Peer-Supervision Of Nursing Professionals: A Shield Against Burnout, Kyle Gamache, Sarah Gamache, Joseph Robillard

Journal of Wellness

Introduction: Burnout is a major risk in healthcare professions and is a significant contributor to the current nursing shortage. Strategies to combat burnout of healthcare professionals are in desperate need. The purpose of this project is to introduce the clinical peer supervision model as a method to alleviate burnout in nursing professionals.

Approach: Eight nurses from in-patient settings participated in a peer-supervision support group, modeled after existing European nursing and mental health provider-support protocols. To assess the effect of this intervention, qualitative data analysis was conducted on the transcripts of session and the results described. All participants reported statistically high …

The Need For Sharps Boxes To Be Offered In The Hospital Setting For People Who Use Substances: Removing Sharps Boxes Puts All Of Us At Risk., Cheryl Forchuk, Michael Silverman, Abraham Rudnick, Jonathan Serrato, Brenna Schmitt, Leanne Scott

Nursing Publications

INTRODUCTION: Substance use can occur in the hospital setting among people with substance use disorder, including intravenous use. However, the provision of sharps boxes is not typically offered in Canadian hospitals. This study set out to explore the current issues due to the lack of harm reduction in the hospital setting.

METHOD: Thirty-one health care professionals participated in virtual one-to-one interviews and focus groups regarding harm reduction in hospital. The issue of sharps box removal was highlighted as a concern. A secondary ethnographic thematic analysis explored this theme in more detail. A scoping review of the literature observed additional considerations. …

Clinical Decision Support System For Standardization Of Disease-Specific Education, Paul Nava

Student Scholarly Projects

The evidence-based, contextually relevant, disease-specific health education materials aim to provide strategies for improvement in health literacy, disease management comprehension, and medication adherence. The health education materials address difficulties many adults experience in understanding health information. The health education system must remain a contextually relevant, patient-specific reference for standardizing disease-specific education according to the patient's mental capability (Fereidouni et al., 2019). Nurse-driven education material system addresses equity, diversity, and inclusion, tailored for all literacy degrees.

Clinical decision-making is a complicated process influenced by a highly variable process that exponentially increases error rates, selection, or exclusion, unintended or not, by presenting …

Treating Opioid Use Disorder: One Shot At A Time, Shelly Haferkamp, Michael P. Kinney, Daniel Yang, Lindsey Cunningham, Anna Davey, Amy G Burns

View All Graduate Medical Education Content

No abstract provided.

Evaluating The Efficacy Of Medication-Assisted Treatment For First Episode Psychosis: A Scoping Review, Chanel Thomas Msn, Aprn, Fnp-Bc, Rn-Bc, Alexandra Wittenberg Bsn, Rn-Bc, Anttrenika Anderson Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that individuals with substance use disorder (SUD) receive medicated-assisted treatment (MAT), as a complete approach to substance use treatment (SAMHSA, 2019). However, treatment measures using combination treatment for SUD in individuals experiencing first episode psychosis (FEP) are seldom used. This scoping review assesses the efficacy of MAT in conjunction with antipsychotics compared to the use of antipsychotic monotherapy for FEP individuals on hospital readmission rates.

Methods

The authors conducted a literature review utilizing PubMed, EBSCO, Elsevier, Google Scholar, PsychINFO, and Medline from August 2020 to November 2022. Key phrases …

Dnp Final Report: Conquering Rn Turnover: Implementing Flexible Scheduling To Improve Job Satisfaction, Camille Y. Parsee

DNP Final Reports

Nurse turnover is a complex problem for the nursing profession, especially in the behavioral health setting, where turnover rates are higher than the overall RN national average. The consequences of high nurse turnover include increased health costs, low-quality patient care, and staffing constraints. The association between nurse turnover and job satisfaction is profound because of their reciprocal relationship; therefore, implementing an intervention to help mitigate nurse dissatisfaction is essential to overcoming nurse turnover. Flexible scheduling is an intervention that gives nurses independence with their schedule which improves work-life balance and promotes nurse retention (Wright, 2017). The following PICOT question was …