Psychiatric and Mental Health Commons^™

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 …

Identification And Mitigation Of Environmental Hazards In Psychiatric Patient Suicide Prevention: A Review, Alan Le

DNP Qualifying Manuscripts

Background: Environmental hazards are a factor in the bulk of inpatient suicide cases, which disproportionately impact psychiatric patients. Current measures to minimize suicide risk include process-oriented solutions and environmental safeguards such as breakaway structures.

Aims: To perform a review of the literature that identifies environmental suicide hazards and interventions implemented to abate hazards and reduce suicide risk.

Methods: Electronic databases were searched using relevant keywords. Inclusion criteria consisted of articles published 2009-2020 that identified environmental suicide hazards or examined efficacy of interventions implemented to abate hazards. The Johns Hopkins Research and Non-Research Evidence Appraisal Tools were used for critical appraisal. …

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 …

Reducing Patient Risk For Suicidal Behaviors With A Safety Bundle Of Best Practices With Non-Psychiatric Patients, Olayemi Akindele

Student Scholarly Projects

Practice Problem: Suicide is a public health condition that affects people globally. The increased suicidal behaviors of patients in a medical-surgical unit demanded an effective screening protocol to identify high-risk patients.

PICOT: In patients 18 years and older on a medical-surgical unit, does the implementation of the Columbia Suicide Severity Rating Scale (C-SSRS) tool and application of a Safety Bundle of Best Practices (SBBP) increase early identification of suicide risk with decreased patient self-harm behaviors, compared to the current standard practice of no assessment tool or safety bundle of best practices within 12 weeks?

Evidence: Ten studies served as evidence …

Depression Symptoms And Covid-19, Kaylee Armendariz

The Eleanor Mann School of Nursing DNP Capstone Projects

The COVID-19 pandemic presents new challenges in behavioral healthcare. Americans may face anxiety surrounding the virus, economic strain, isolation, and grief, putting them at increased risk for depression symptoms. This Doctor of Nursing Practice (DNP) quality improvement project aimed to increase depression screening rates and utilized data from a Federally Qualified Health Center (FQHC) to identify population groups at higher risk for depression symptoms during the COVID-19 pandemic. Using the Patient Health Questionnaire (PHQ) depression screening tool, a statistical analysis determined if being tested for COVID-19 or testing positive for COVID-19 had an impact on depression symptoms. Additionally, this project …

The Effect Of Covid-19 On The Mental Health Of College Athletes, Molly Mcardle

Senior Theses

This research aimed to explore how the mental status of student athletes at the University of South Carolina has been affected by the unprecedented COVID-19 pandemic. A total of 61 student athletes between the ages of 17 and 24 participated in the study and completed a series of questions including the Depression-Anxiety-Stress Scale 21 (DASS-21) and the Group Environment Questionnaire (GEQ). Independent samples t-tests and descriptive analyses were used for comparisons between gender and age. The results showed that female athletes reported statistically significantly higher levels of anxiety and stress than male athletes (p = 0.049 and p = …

Mental Health Of Children And Adolescents Amidst Covid-19 And Past Pandemics: A Rapid Systematic Review, Salima Meherali, Neelam Punjani, Samantha Louie-Poon, Komal Abdul Rahim, Jai K. Das, Rehana A. Salam, Zohra S. Lassi

School of Nursing & Midwifery

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children's and adolescent's mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children's and adolescents' mental health.
Methodology: We conducted …

The Effects Of Administrative Support On Registered Nurse Well-Being During The Covid-19 Pandemic, Cassandra Fox

The Eleanor Mann School of Nursing DNP Capstone Projects

Attention to the well-being of nurses is necessary to ensure the healthcare system can operate effectively, particularly during the COVID-19 pandemic. The workplace environment and support from nursing leadership strongly contribute to nurses’ well-being. Currently, there is little evidence on the effect nursing leadership has on nurses’ well-being during the COVID-19 pandemic. This DNP clinical inquiry project sought to learn more about the effects of caring leadership behaviors on nurses’ well-being during the COVID-19 pandemic. A survey composed of questions from previously validated and reliable surveys used in the field of nursing was used to collect data. Neuman’s systems theory …

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). …

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff’s confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …

Caring For The Caregiver: Second Victim Recovery Following A Serious Medical Error, Beulah Patrice Vance

Walden Dissertations and Doctoral Studies

In 1999, it was estimated that 98,000 deaths were attributed to medical errors and were the fourth most common cause of death in the United States. In 2016, medical errors were estimated as the third leading cause of death, with a mean death rate of 251,454 each year. Nurse involved in errors are known as second victims. Almost one in seven staff members reported that they had experienced a patient safety event within the last year that caused personal problems such as anxiety, depression, or concerns about their ability to perform their job. This project explored whether nurses are able …

Improving Employee Mental Health: Addressing Depression At The Workplace, Gerald G. Chia Dr.

DNP Scholarly Projects

Abstract Background: Depression is a serious mental health challenge in the US. As frontline workers who are responsible for taking care of a myriad of patients daily, health workers are usually exposed to depressive situations which eventually results in them developing the mental health condition. The purpose of the current project was, therefore, to develop an intervention which helps to improve employee mental health in healthcare settings with focus on depression and examine workplace factors which influence depression among employees of the Outpatient Mental Health Clinic in Washington District of Columbia. Methods: A pre-intervention survey was conducted among 43 employees. …

Differences In Smoking Behaviors And Readiness To Change For Patients With Copd And Differing Categories Of Depression, Jessica M. Floyd

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world. Depression is a common comorbidity of COPD and affects patient outcomes and smoking cessation. The purpose of this study was to explore and describe factors influencing smoking behaviors and readiness to change in patients with comorbid COPD and depression.

Aims: The research question that guided this study was, “What are the relationships among smoking, COPD, and depression?” The following aims stemmed from the research question: to describe the characteristics of a convenience sample of people living with COPD and differing categories of depression who …

Social Media And Mental Health In Adolescents And Young Adults: A Systematic Review, Dawn Ritter, Kimberly Ray, Celia Keefe

Williams Honors College, Honors Research Projects

The goal of our project is to increase understanding of the link between social media use and mental illness in teens and young adults. Our objective is to write a systematic review of the literature to answer the PICOT questions: (1) In teens and adults, younger than 25 years, what is the relationship between social media use and mental illness? (2) In teens and adults, younger than 25 years, what is the effect of interventions, such as social media as a resource, on mental health promotion and well-being? The motivation for our project comes from the increased use of social …

Anxiety Screening In Children & Adolescents With Type 1 Diabetes Using The Gad-7 Tool, Allison B. Reynolds

DNP Projects

BACKGROUND: Children and adolescents with type 1 diabetes (T1DM) can encounter a variety of factors that affect proper management of their diabetes, including mental health. Youth with diabetes have significantly higher rates of depression, anxiety, and mental health problems compared to the general population. Anxiety is especially prevalent. PURPOSE: The objective of this project was to evaluate anxiety screening of children and adolescents with T1DM during their routine diabetes visits. Specifically, to assess for any trends in anxiety levels and patient characteristics including demographics, insulin regimen and A1C levels. METHODS: A cross- sectional, retrospective review of ambulatory electronic health records …

Educational Strategies For Healthcare Providers Of Postpartum Women With Substance Use Disorder, Agnes Denise White

Walden Dissertations and Doctoral Studies

AbstractProviding educational strategies to maternal-child staff members can improve their attitudes, perceptions, and stigma towards the childbearing age women who are substance users. In the United States, an increased number of pregnant women have substance abuse problems. It is important that the maternal child staff have the resources and are equipped to care for women who are substance users struggling with their addictions and motherhood. The purpose of this project was to determine whether an educational program provided to postpartum nurses increased knowledge on the special needs of the new mother with a substance abuse issue. The education of the …

Effects Of Attribution And Appraisal Of Control On Emergency Department Nurse Stress When Treating Patients With Severe Mental Illness, Cynthia Lynn Bentzen-Mercer

Walden Dissertations and Doctoral Studies

AbstractAs the prevalence of severe mental illness continues to rise and access to mental health care is scarce, an increasing number of U.S. adults seek treatment in emergency departments. Nurses who triage the severity of a medical emergency may appraise the situation both through the lens of mental illness stigma and the degree of confidence they have to control the outcome. However, the research community knows little about the extent to which attribution and appraisal of control affect nurses’ appraisal of stress. The purpose of this quantitative nonexperimental, canonical correlational study was to examine the extent to which various combinations …

A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas

Walden Dissertations and Doctoral Studies

High utilization of the emergency department (ED) by patients with anxiety symptoms has brought attention to mental health access disparities among low-income racially/ethnically diverse populations. The health system in this study attempted to increase access to mental health care with integrative group medical visits (IGMVs), a nonpharmacological intervention with biomedical care consultation, health education, and peer support. The purpose of this retrospective comparative analysis, guided by integrative health equity in primary care framework, was to determine whether patients with diagnoses of anxiety who attended four or more IGMVs had reduced nonemergent ED utilization, reduced prescribed doses of benzodiazepine (BZD), and …

Maternal Depression Trajectories And Child Bmi In A Multi-Ethnic Sample: A Latent Growth Modeling Analysis, Charlotte V. Farewell, Ryley Donohoe, Zaneta Thayer, James Paulson, Jacinda Nicklas, Caroline Walker, Karen Waldie, Jenn A. Leiferman

Psychology Faculty Publications

Background

Perinatal (antenatal and postpartum) depression impacts approximately 12% of mothers. Perinatal depression can impact everyday functioning for mothers, and the relationship with, and development of, their children. The purpose of this study was to investigate depression trajectories from the antenatal period through 54-months postpartum and associations with child body mass index at 54-months postpartum.

Methods

This study applied latent growth modeling to the Growing Up in New Zealand study, which is a longitudinal pregnancy cohort study that provides nationally representative-level data, to investigate associations between depression at three time points (antenatal, 9-months postpartum, 54-months postpartum) and child body mass …

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff's confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …

A Clinical Practice Guideline For Measuring Quality Of Life In Patients With Depression And Anxiety, Mary Fowaah Boateng

Walden Dissertations and Doctoral Studies

Mental health conditions affect various aspects of an individual’s quality of life (QOL). Patients with anxiety and depression have a greater risk of having a negative perception of QOL. The gap in practice was the lack of an assessment tool to measure QOL in patients with mental health disorders. The purpose of this Doctor of Nursing Practice project was to develop a clinical practice guideline (CPG) recommending the best evidence-based measurement tool for QOL in patients with anxiety and/or depression. The question that guided the CPG was: How should QOL be measured in patients with anxiety and/or depression in the …

Improving Care Transitions For Individuals With Suicide Risk After Discharged From Acute Unit, Maureen Ndu

DNP Scholarly Projects

Background: Suicide is a public health problem and the 10th leading cause of death in the US. Suicide accounted for more than 47,5000 deaths in the US in 2017, translating to about 130 suicide deaths each day. An average of 20 veterans commits suicide each day compared to 93 suicides in the general population in the US. Individuals with suicide risks are 300 times at an increased rate of suicide death in the first week and 200 times in the first month of hospital discharge. Nurses are in a strategic position to improve the care transition of individuals with suicide …

The Crossroads Of Wellness And Second Victim Syndrome: Identifying Factors That Alter The Pathway Of Caregiver Recovery Following An Unanticipated Adverse Patient Outcome, Kimia Zarabian, A. Katharine Hindle, Ivy Benjenk, Anita Vincent, Jamil M. Kazma, Benjamin Shambon, Raymond Pla, Eric Heinz

Journal of Wellness

Introduction: Second Victim Syndrome (SVS) describes the phenomenon in which a caregiver experiences a traumatic psychological and emotional response to an adverse patient event or medical error. Using quantitative survey analysis, we aim to better understand the personal factors that affect SVS development and recovery.

Methods: Caregivers at a small urban academic medical center who had experienced an adverse patient event in the past six months were invited to take part in this institution-wide, voluntary, quantitative, cross-sectional study. Three surveys were administered; the Holmes-Rahe Life Stress Inventory (HRLSI) was used as a surrogate to measure stressful life events. The …

Three Good Things To Extinguish Caregiver Burnout, Justin Haley

Master's Projects and Capstones

Caregiver burnout is a widespread issue in healthcare and institutions should be increasingly concerned about burnout because of the significant impact on quality of patient care, employee health, and financial stability. Many interventions and studies regarding burnout are focused on improving systems issues or removing negative stressors on caregivers. Although such interventions may be necessary to attempt, comprehensive systems-wide changes can be cumbersome and expensive, while removing negative stressors may be an unrealistic goal in a fast-paced, demanding healthcare environment. The Three Good Things method is an evidence-based, effective, simple, low-cost intervention to improve feelings of caregiver burnout in which …

Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario

Doctor of Nursing Practice (DNP) Projects

Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change.

Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression …

Reducing Suicide By Providing Cognitive Behavioral Therapy For Suicide Prevention, Wendy Larkin

Student Scholarly Projects

Veteran suicide is a serious and persistent national problem, which demands an effective treatment intervention. This Evidence-Based Practice project (EBP) addressed the question: Do patients with a psychiatric in-patient diagnosis of suicide ideation, who after discharge self-elect outpatient Cognitive Behavioral Therapy-Suicide Prevention (CBT-SP) treatment over a 6-week time frame, reduce the likelihood of hospital readmission for suicidal ideation vs. patients who decline CBT-SP treatment and elect Treatment as Usual (TAU)? The literature is prolific in validating that CBT-SP is successful in determining the effectiveness of CBT-SP vs. TAU in reducing suicidal behaviors in adults.

Hospital readmission data were collected on …

Implementing Trauma-Informed Care Early In The Lives Of Children And Adults, Carley Clymer

Scholars Week

Throughout the health care industry, providers are failing to recognize the implications that adverse childhood experiences (ACEs) have upon adult health. As a result, these patients not only have to endure these traumas, but they’re also faced with crippling health conditions that accompany them including depression, heart disease and obesity. The prevalence of common high-risk behaviors such as smoking, drinking and illicit drug use can also co-exist with adversity, which leads to an exacerbation of already poor health. This presentation aims to relay the significance of adopting a trauma informed care (TIC) approach early in the lives of clients to …

Implementing Mandatory Psychiatric Training For Medical-Surgical Nurses, Hannah Berry

Scholars Week

Hospitals worldwide experience poor outcomes for patients with mental illnesses. Psychiatric patients have a lesser likelihood of surviving a particular illness than does a person with that same illness who does not have a psychiatric comorbidity. This is a bleak reality that nurses have the unique opportunity to influence for the better. Destigmatizing mental illness is perhaps the largest component of stepping toward this goal. Our nurses being more educated on the nature of mental illnesses—their signs, symptoms, and common treatments—will improve care outcomes for patients who suffer from them. Not only should we educate nurses on mental illness for …

Recommending That School Nurses Provide Mental Health Screenings To Students, Mariah Dufault

Scholars Week

Childhood mental health issues not being identified early, caused by a lack of knowledge and awareness in childhood mental health, can lead to lifelong debilitating issues. The Center for Disease Control states, “Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, which cause distress and problems getting through the day” (CDC 2020). These issues can lead to negative self-worth, a lack of ambition, thoughts of self-harm, aggression towards others, and suicidal ideations. Studies have even shown that, “Half of adults with mental health disorders report or have been shown …