Psychiatric and Mental Health Commons^™

The Crisis In Male Mental Health: A Call To Action, Demetrius Porsche, Salvatore J. Giorgianni

School of Nursing Faculty Publications

No abstract provided.

Schizophrenia And Genomics, Tiffini Lasch

Nursing Student Class Projects (Formerly MSN)

There are several advancements in genomics under specific categories, such as cancer and autism. Mental health is one of the leading diseases to cause a significant debt burden in today's society. However, genomics has not translated well into mental health treatment. One area of focus is schizophrenia. Those with schizophrenia suffer from severe and devastating symptoms. The symptoms can lead to harsh complications. Which can make it impossible to function in everyday life. Many believe it is not just genetics alone, but also environmental factors that contribute to schizophrenia. Through large genome-wide associated studies, discoveries are being made. There have …

A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula

Nursing Masters Papers

Abstract

Delirium is a complex syndrome resulting from compounding effects of acute illness, comorbidities, and the environment. It results in adverse outcomes: elevated mortality rates, length of stay, readmissions, institutionalization, long-term cognitive changes, and diminished quality of life. The rate of iatrogenic delirium is astounding, ranging from 10%-89%. There are no curative treatments; thus, primary prevention is the key. The purpose of this literature review is to identify and critique the research for the accuracy of risk stratification and feasibility in practice. Support for interventions that prevent delirium is mounting; however, interventions are resource-intensive and often not implemented. Researchers have …

Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Mental Health Screening For Low-Income Adolescents

BACKGROUND: Nearly 80% of adolescents in the United States will suffer from a mental illness and not receive evaluation or services. Children from low socio-economic backgrounds have an increased risk of mental health disorders which permeate into adulthood, leading to additional negative sequel and lower quality of life. Among adolescent mental health conditions, depression and anxiety are the most common. Literature has suggested provider intuition alone has low sensitivity and specificity for detecting mental illness and that screening tools are indicated.

PURPOSE: The aim of this project is to implement standardized routine …

Barriers And Facilitators To Opioid Use Treatment And Recovery Services During Pregnancy, Loralie Woods

Dissertations

Purpose: To identify barriers and facilitators to opioid use treatment and recovery services among pregnant and nonpregnant women who misuse opioids.

Background: Over 130 Americans die daily after overdosing on opioids. Women have not been immune from opioid use disorders (OUDs), with a 4-fold increase from 1999-2010. The prevalence of opioid use among pregnant women increased from 1.5 per 1,000 hospital deliveries to 6.5. Although the annual National Surveys on Drug Use and Health (NSDUH) has provided information on risk factors for OUD related to socioeconomic and demographic factors, no studies using this data have identified barriers to opioid use …

It's More Than Just "Baby Blues" - Screening For Postpartum Depression In A Pediatric Setting, Breanna M. Lazar, Martha G. Fuller

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Postpartum depression (PPD) is estimated to affect up to 1 out of 7 women. Evidence and American Academy of Pediatrics (AAP) guidelines support maternal screening for PPD in a pediatric setting during well-child visits. The pediatric office is frequently visited during the first year of life and is a suitable setting to perform screening.

Aims of Service Change: Implement AAP recommended PPD screening at a busy primary care practice in Southern California using the Patient Health Questionnaire (PHQ-9).

Details of Innovation: In this pilot project, mothers (who were not patients of the pediatric practice) consented to be screened …

A Dnp-Led Educational In-Service To Increase Depression Screening In Primary Care, Shaylyn White

Doctor of Nursing Practice Final Manuscripts

Background: Depressive disorders are a major contributor to disability in the United States and worldwide. They are associated with multiple comorbid conditions including cardiovascular disease, obesity, stroke, and premature mortality. In the US, only 4.2% of primary care patients are being screened for depression and approximately 50% of cases of major depression are being missed.

Purpose: Implementation of a nurse practitioner-led educational intervention, discussing when, why, and how to screen utilizing the PHQ-2 and PHQ-9 screening tools, with the medical assistant staff in order to increase compliance with annual screening.

EBP Model/Frameworks: The Iowa model was used to guide implementation …

Public Stigma And Self-Stigma Of Depression In College Students, Peyton Lee

DNP Projects

A large body of literature portrays the long-term, increased presence of mental illness stigma in college students, a vulnerable population at high risk of victimization. However, literature lacks sufficient research differentiating between the separate forms of mental illness stigma as well as consistent research examining stigma specific to the mental illness of depression in college students. A cross-sectional, web-based survey design was utilized to collect quantitative data from 432 students at a private, four-year university in the southeastern United States. The primary investigator both described the presence of and relationship between levels of perceived public stigma, personal public stigma, and …

Awareness Of The Unaware: Anosognosia As A Comorbidity In Mental Health Conditions, Tiffany L. Baula

Honors Undergraduate Theses

The primary purpose of this integrative review of the literature is to describe healthcare provider’s recognition of anosognosia in individuals with comorbid mental health disorders, as a differentiating diagnosis needing preeminent early intervention. The secondary purpose is to examine how anosognosia influences outcomes in the population of individuals with severe mental illness. It is expected that early recognition by clinicians and implementation of additional interventions to address anosognosia as the most influential comorbidity of schizophrenia, will decrease exacerbations and improve treatment and patient outcomes.

A literature review exploring clinician’s acknowledgement of anosognosia was performed using various databases. Search terms included: …

Understanding The Experiences Of Young Adults Receiving Community-Based Eating Disorder Care, Hali Sitarz

Walden Dissertations and Doctoral Studies

AbstractIn Ontario, Canada, eating disorder care is predominately delivered through nurse practitioner-led community outreach programs; however, there is a paucity of evidence informing the role of nurses in terms of outpatient treatment, community-based care, and young adult patient experiences. With high rates of morbidity and mortality, it is imperative to establish an evidence-informed approach to eating disorder treatment and ensure that care is patient-centered. This interpretive phenomenological study explored the experiences of young adults receiving community-based treatment in Ontario. Reigel, Stromberg & Jaarsma’s Middle Range Theory of Self-Care in Chronic Illness was used as an orientating framework. Seven young adults, …

Eating Disorders And The Gap Of Education, Sara Jane Camden

Walden Dissertations and Doctoral Studies

Eating disorders are described as excessive dieting, limiting food intake, and withholding of food. Over 30 million people suffer from eating disorders. Some people may also have preconceived notions that this disease is easily fixable and that eating more and stopping dieting will solve the problem. Registered nurses struggle with having preconceived ideas, a lack of confidence in their assessment skills, and fear of using the eating disorder diagnosis. Barriers that have surrounded the eating disorder mental health disease need to be addressed. The staff development project was based on the question if nursing knowledge would improve on eating disorders …

Family Functioning During Deployment And Reintegration Of Military Members, Heather Graham

Walden Dissertations and Doctoral Studies

Military members and their families face unique stressors related to separation and reintegration. These life-changing events can lead to domestic violence, divorce, depression, suicide, and behavioral problems within the family. It was unknown whether the implementation of a nursing clinical practice guideline (CPG) would help nurses to identify family functioning concerns or psychosocial issues enabling earlier interventions. The purpose of this doctoral project was to create a CPG that can be used at military treatment facilities (MTFs) to screen military members and their families to identify family functioning concerns so that the provider can make referrals as needed. The circumplex …

Improving Suicide Prevention In The Emergency Department, Crystal Hartis Andrews

Walden Dissertations and Doctoral Studies

Suicide is a leading cause of death and a significant public health problem in the United States, especially among the youth population. The wide variability of screening practices and limited educational programs for nurses in terms of identification and management of individuals at risk for suicide exists. The purpose of this project was to conduct a systematic review to identify evidence available in support of adequately preparing nurses to conduct suicide screening and inform suicide prevention efforts for youth in emergency departments. Results from the literature review were correlated to formulate recommendations for improving suicide screening practices through the provision …

Staff Instruction On Patient Health Questionnaire And Collaborative Care Model In Primary Care, Jennifer Carton

Walden Dissertations and Doctoral Studies

The DNP project examined the effectiveness of the Patient Health Questionnaire-9 (PHQ-9) and the Collaborative Care Model (CCM) as a practice protocol for patients suffering from depression in primary care to address the problem of a shortage in mental health specialists. Research reveals an increase in Americans suffering from depression. Many primary care clinics do not have a practice protocol in place to screen and manage depression. The project's purpose was to develop a lesson plan to instruct staff on the PHQ-9 and CCM to implement into their practice. The project questions were if the lesson plan developed by the …

Effect Of Educational Training On Nurse Leaders’ Knowledge, Attitude, And Behavior Toward Suicide Prevention, Ruth Odochi Idediora

Walden Dissertations and Doctoral Studies

Suicide is the 10th leading cause of death among adults in the United States and one of the top 10 most commonly occurring events that lead to serious injury or death in the hospital. Nurse leaders who are not working in psychiatric facility are instrumental in promoting culture of safety to mitigate adverse outcomes like suicide. The purpose of this single group pre-and post-test study, guided by the theory of planned behavior, was to determine the effect of the American Psychiatric Nurses Association Competency-Based Training for Suicide Prevention (Acute Care Setting Course) on the knowledge, attitude, and behavior (KAB) of …

Staff Education Program For Nurses Caring For Patients With Medical Decline On A Geriatric Psychiatric Unit, Portia Denise Risper

Walden Dissertations and Doctoral Studies

AbstractElderly patients admitted to psychiatric units are a vulnerable population, some may have mental disorders, physical decline, cognitive challenges; along with other comorbidities in addition to their mental illness. However, their physical health needs may be overlooked due to the presenting behaviors mimicking mental health behaviors. The nurses working in the local hospital facility’s geri-psych unit failed to recognize signs and symptoms of physical decline in their severely mentally ill (SMI) patients. Not recognizing and reporting acute changes resulted in patients’ prolonged hospitalization, decreased quality of life, and increased cost to the facility. The purpose of this DNP project was …

Ontrack: A Program Evaluation, Justin Mynatt

Doctoral Projects

OnTrack is a program that provides coordinated specialty care (CSC) services for patients who have experienced their first episode of psychosis (FEP). Appropriately identifying and aggressively treating this vulnerable population, while providing support to both them and their families is critical for improved outcomes. Appropriate treatment of FEP patients can improve their quality of life, preserve brain matter, improve overall functioning, and lessen the burden of the clients’ family who may be involved in their care, such as caregiver strain or financial hardship. The purpose of this project is to evaluate the success of OnTrack, a FEP program, at improving …

Improving Provider Adherence To Guidelines And Screening For Adult Depression In Primary Care, Amber Crenshaw

Doctor of Nursing Practice

The purpose of this QI project was to improve provider adherence to the Institute for Clinical Systems Improvement (ICSI) Guidelines for Adult Depression in Primary Care to enhance the screening, diagnosis, treatment, and management of adult major depressive disorder (MDD). MDD is a widespread, disabling, and treatable psychiatric disorder that is primarily treated and managed by primary care providers (PCPs). Untreated depression is prone to become chronic and can lead to pain, suffering, disability, increased morbidity and mortality, and premature death, with serious repercussions for the individual and society. Universal and routine screening in primary care for depression in adults, …

Development Of A Text Message Stress Management Intervention And Its Impact On Perceived Stress And Coping Self-Efficacy Among Student Nurses, Kristin Jaye Henderson

Graduate Theses and Dissertations

Purpose: The purpose of the two studies was to develop a text message intervention and examine its effects on lowering perceived stress and increasing coping self-efficacy among nursing students. We also explored stress perceptions and investigated student satisfaction with the text message stress management program. Methods: For the first study, twenty three students participated in the focus groups for intervention development. Sample messages were presented to participants and feedback was requested. The messages were modified based on student feedback. The second study utilized an experimental pre/post design with a convenience sample (N=101) to examine the effects of the text message …

Psychosocial Factors Of Deliberate Self-Harm In Afghanistan: A Hospital Based, Matched Case-Control Study, Akbar Paiman, Murad M. Khan Dr., Tazeen S. Ali, Nargis Asad, Iqbal Azam Syed

Department of Psychiatry

Background: Deliberate self-harm is not only a major global public health problem but also an important index of psychological distress and a risk factor for suicide.
Aims: We aimed to determine the psychosocial risk factors for deliberate self-harm in patients aged ≥ 16 years presenting to tertiary care hospitals in Kabul, Afghanistan.
Methods: A matched case-control study was conducted from February 2015 to May 2015. We recruited 185 cases (patients with deliberate self-harm) and 555 age- and sex-matched controls (patients with general medical conditions) from 4 tertiary care hospitals in Kabul. We developed a questionnaire to record the sociodemographic characteristics …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Wellness Review 2019, Part 1, Martin Huecker, Brian A. Ferguson

Journal of Wellness

Welcome to the first Journal of Wellness review of recent literature. Wellness leaders are aware that a literature search yields thousands of articles on burnout, less on wellness, and no consistent, reliable source of publication. This validates the mission of JWellness, to collect editorials and research in one location, free for all to read and publish, allowing dissemination to all healthcare professionals.

Treating Substance Use Disorders: Enhancing Attendance At The Weekly Inpatient Medication Assisted Treatment Group, Devon Gillis, Jayne Weisberg, Dena Whitesell, Amy Mcauliffe, Amy Sparks, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Operations Transformation

At a large academic tertiary medical center, an Integrated Medication Assisted Treatment (IMAT) program has been established for those medically stable inpatients with an addiction diagnosis. Over a four month period, this program had experienced a decline in attendance and a quality improvement project was initiated is to better understand the barriers to attendance and institute a process that would reverse the decline.

A goal was established to improve attendance by medically stable patients that have consented to participate to a minimum of 50%.

A root cause analysis outlined numerous causes for low attendance and several countermeasures were established to …

Implementation Of An Evidence-Based, Electronic Clinical Algorithm To Improve Screening, Evaluation, And Referral Of College Students For Depressive Symptoms And An Evaluation Of Differences Based On Sexual Orientation And Gender Identity Data, Chris Webb

Graduate Theses, Dissertations, and Capstones

The purpose of this project was to improve the screening, evaluation, and referral of college students (LGBTQ+/Heterosexual) for depressive symptoms through the implementation of an evidence-based, electronic clinical algorithm. There is evidence in the literature indicating that there are increased mental health disparities among college students and the LGBTQ+ population. The prevalence of depressive symptoms among university students is higher than the general population, requiring university student health centers to implement enhanced screenings for depressive symptoms and identification of depression predictors. Prior to implementation of this project, a student health clinic in the Southeastern part of the United States used …

Barriers To Mental Health Treatment In Patients Referred By Primary Care, Rebecca Palmer

Dissertations

Problem: Limited access to mental health treatment is one of many potential barriers to treating mental illness in the United States. Where resources are readily available, reportedly high no-show rates for established mental health appointments suggests further investigation is necessary to identify frequent barriers within that population. This was a quality improvement project to identify common themes in patient-reported barriers to care.

Methods: A 4-question phone survey was offered to individuals that did not appear at their mental health appointment. Data was analyzed to identify the most commonly reported barriers to mental health treatment. Additional data collected includes reported history …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Do Not Miss Your Shot: Improving Follow-Up In Patients Receiving Long-Acting Injectable Medications, Mary O'Hara

Doctor of Nursing Practice Final Manuscripts

Background: Serious mental illness including schizophrenia and bipolar disorder affects 1 in 24 adults in California. These chronic disorders are difficult to treat and often sabotaged by medication nonadherence. Long-acting injectable (LAI) medications are one strategy to combat medication nonadherence. Effectively providing treatment with LAI medications can be challenging at the clinic level.

Objectives: Reduce the number of days without medication by reducing the number of days between injection due date and injection administration for patients receiving LAI medications.

Design: Establish appointments for all injection visits. Standardize visit protocol for injection encounters to optimize provider time. Arrange immediate follow-up and …

A Multi-Component Education, Skill, And Resource Evidence-Based Practice Intervention For The Alzheimer’S Caregiver, Cheryl Garmon

DNP Final Reports

Abstract

Dementia caregiving is expensive, stressful, and consumes all facets of the caregiver’s (CGs) life. The purpose of this project is to introduce the evidence-based practice (EBP) interventions most helpful in decreasing stress and burden in those who are in-home caregivers for Alzheimer’s disease and related dementias (ADRD) individuals.

The three primary intervention domains of the EBP studies that results in a positive impact are; providing education about the terminal course of the disease, introducing communication and caregiving skills, and furnishing resource and social network information.

The methodology included a convenient and voluntary population of CGs who sought service at …

Implementation Of An Evidence Based Screening Protocol To Improve The Diagnosis Of Dementia In A Home-Based Primary Care Setting, Lauren Liesbeth Sutton

Doctoral Projects

Dementia is a major public health concern that is both debilitating and deleterious to those afflicted with its various forms. The number of those living with dementia is increasing exponentially as the population continues to rise, with 46.8 million people worldwide currently afflicted with dementia (Chow et al., 2018). Dementia causes cognitive impairment that is severe enough to affect everyday function (Chow et al., 2018). The impairment and disability resulting from dementia indicates a significant health problem in primary care. Findings from research studies indicate that prophylactic and periodic screening for dementia can heighten provider suspicion and translate into earlier …

Reducing Antipsychotic Medication Use In Long-Term Care Settings, Martha Ofeibea Agbeli

Walden Dissertations and Doctoral Studies

The prescription rate of antipsychotics in patients with dementia varies between 20% and 50% for the common and troubling neuropsychiatric symptoms experienced by patients with dementia. The use of these antipsychotic medications has been linked with increased risk of morbidity and mortality due to associated Parkinsonism, over sedation, gait disturbances, cognitive decline, and cardiovascular adverse events. The purpose of this project was to assess whether development of an evidence-based clinical practice guideline (CPG) for a long-term care facility would increase awareness about issues that govern the safe use of antipsychotic medications. The conceptual framework for the project was Watson's model …