Mental and Social Health Commons^™

Medicated-Assisted Treatment And 12-Step Programs: Evaluating The Referral Process, Candace S. Brown, Chudney Williams, Ryan E. Stephens, Jacqueline Sharp, Bobby Bellflower, Martinus T. Zeeman

Doctor of Nursing Practice Projects

Purpose/Background Overdose deaths in the U.S. from opioids have dramatically increased since the COVID-19 pandemic. Although medicated-assisted treatment (MAT) programs are widely available for sufferers of opiate addiction, many drop out of treatment prematurely. Twelve-step programs are considered a valuable part of treatment, but few studies have examined the effect of combining these approaches. We aimed to compare abstinence rates among patients receiving MAT who were referred to 12-step programs to those only receiving MAT.

Methods In this prospective study, a cohort of participants from a MAT clinic agreeing to attend a 12-step program was compared to 15 controls selected …

Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C

Doctor of Nursing Practice Projects

Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.

Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …

Postpartum Depression: Development Of A Screening Protocol In The Neonatal Intensive Care Unit, Kelsey T. Langdale

Doctor of Nursing Practice Projects

Postpartum depression (PPD) affects approximately 19% of all postpartum women. Evidence indicates an increased risk for mothers of hospitalized infants, with estimates ranging from 28% to 67%. The American Academy of Pediatrics and Bright Futures recommend mothers be screened for postpartum depression at the infants’ well-child appointments. During hospitalizations, there are no well-child appointments; thus, no postpartum depression screening. This project aims to 1) improve knowledge of PPD in the staff of the Neonatal Intensive Care Unit (NICU) and 2) investigate the staff’s interest level in implementing a PPD screening protocol. Utilizing the Plan-Do-Study-Act (PDSA) framework, a protocol was developed …

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).

Methods We conducted a retrospective chart review on patients …

Efficacy Of Integrating Cbt For Mental Health Care Into Substance Abuse Treatment In Patients With Comorbid Disorders Of Substance Abuse And Mental Illness, Laura U. Madu, Jacqueline Sharp, Bobby Bellflower

Doctor of Nursing Practice Projects

Abstract: Multiple studies have found that psychiatric disorders, like mood disorders and substance use disorders, are highly comorbid among adults with either disorder. Integrated treatment refers to the treatment of two or more conditions and the use of multiple therapies such as the combination of psychotherapy and pharmacotherapy. Integrated therapy for comorbidity per numerous studies has consistently been superior to the treatment of individual disorders separately. The purpose of this QI project was to identify the effectiveness of Cognitive Behavioral Therapy (CBT) instead of current treatment as usual for treating Substance Use Disorder (SUD) or mental health diagnosis independently. It …

Improving Psychological Trauma Awareness For Culturally Responsive Care: A Dnp Project, Jose M. Cruz

Doctor of Nursing Practice Projects

Racism and racial discrimination occur in a variety of forms (Kendi, 2017). Both can contribute to poor mental health outcomes in the United States (Alvarez, Liang, & Neville, 2016; Comas-Diaz, Hall, & Neville, 2019; Levy, 2019; Malott & Schaefle, 2015; Williams, Lawrence, Davis, & Vu, 2019). These social conditions have been identified as chronic stressors that can illicit trauma symptoms, result in post-traumatic stress disorder (PTSD), and contribute to increased suicidality (French et al., 2020). Providers should understand the ramifications of the psychological trauma that can occur and endeavor to deliver evidence-based solutions. This doctoral project was designed to develop, …

A Protocol For Improving Early Recognition And Treatment Of Bipolar Disorder, Zelluyah Gaitho

Doctor of Nursing Practice Projects

In bipolar disorder, patients present to a clinician during depressive episodes often leading to a misdiagnosis. In turn, this could lead to inappropriate treatment. This failure to diagnose could be attributed to lack of use of validated screening tools and deviation from clinical guidelines. The purpose of this quality improvement project was to develop a protocol that will help improve early recognition and treatment of bipolar disorder by using the Mood Disorder Questionnaire. A training program was developed to increase knowledge on the proper use of the Mood Disorder Questionnaire (MDQ) and the Quality-of-Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). …