Psychiatric and Mental Health Commons^™

Staff Education Intervention To Enhance Care Planning For Older Adults, Mozhgan Peiravi

Walden Dissertations and Doctoral Studies

The increased prevalence of cognitive deterioration has increased the challenges of caring for older adults. This study's project site offers a psychiatric program for older adults with customized care for complex geriatric mental health patients. Clinical assessment and care management are often overlooked in geriatric mental health patients diagnosed with behavioral and psychological symptoms of dementia (BPSD). The purpose of this project was to deliver an education program developed from the Staff Training in Assisted Living Residences-Veterans Administration, P.I.E.C.E.S model and the Castle framework to 42 nursing and allied health staff of the project site. The project question explored whether …

Primary Care And Behavioral Health Services In A Federally Qualified Health Center, Svetoslav A. Arsov

Walden Dissertations and Doctoral Studies

Between 2013 and 2016, 8.1% of U.S. adults 20 years and older suffered from depression, but only 29% of them sought help. This project addressed the low depression screening rate in a Federally Qualified Health Center (FQHC) that supported integrated care. The purpose of the project was to evaluate the integration of behavioral health into primary care in an FQHC through the rate of depression screenings. Two theoretical frameworks, the find-organize-clarify-understand-select/plan-do-study-act model and the Centers for Disease Control and Prevention's framework for program evaluation in public health were combined into a list of questions and data validity tests that were …

Best Practice Suicide Screening/Assessment Tools For The Emergency Department, Katheryn M. Spirito

Walden Dissertations and Doctoral Studies

Patients presenting to the emergency department (ED) often suffer from more than physical ailments when seeking care and treatment. Some of these patients have emotional ailments and suicidal ideation when they come to the local ED. The lack of recognition of at-risk patients by health care providers can lead to poor patient outcomes and death. The focus of this project was to understand which valid and reliable suicide assessment tools described in the literature were considered the best evidence-based instruments to identify ED patients who were at risk for suicide. Peplau's theory of interpersonal relations guided this project. A systematic …

Prescreening Recommendations For Patients On Medical Cannabis, Wen Chieh Hu

Walden Dissertations and Doctoral Studies

Marijuana is the most frequently used illegal substance in the United States and is most widely used among young people aged 12 to 21 years. Accurate screening and monitored issuance of medical cannabis recommendations have been shown to decrease abuse rates of the substance, create fewer deaths from opiates, reduce crime rates, reduce marijuana use in youths, decrease car crash deaths, and lessen prevalence of suicide in young men. The purpose of this project was to explore whether multiple screening methods for depression and anxiety in patients who seek medical cannabis referrals for anxiety and depression would improve screening and …

The Effects Of Compassion Fatigue On Burnout Among Inpatient Psychiatric And Intensive Care Unit Nurses, Amita Madan Neidlinger

DNP Projects

PURPOSE: This DNP project is relevant to nurses of the psychiatric and Intensive Care Unit (ICU) setting, as high stress environments may produce higher rates of compassion fatigue and burnout. Investigation of these areas may help illuminate unnecessary healthcare costs that are associated with these phenomena. This DNP project is important to the University of Kentucky’s healthcare system, its patients, and nurses. Increased absenteeism and increased medication errors are positively associated with the prevalence of compassion fatigue and burnout in nurses. Outcomes from this project will allow identification of unnecessary healthcare costs and encourage administrators to focus on reducing nurse …

Depression Screening At A Mental Health Outpatient Clinic: A Quality Improvement Project, Renee Licorish

Doctor of Nursing Practice

Project Background: Depression is one of the most common mental health problems in the United States. Many individuals may seek treatment but go undiagnosed due to the lack of recognition by clinicians. Clinical guidelines recommend the use of a standardized depression screening tool within a clinician’s evaluation process. The Patient Health Questionnaire 9 (PHQ-9) is such a tool and recommended for use in the outpatient care setting. Aims of the Project: To increase depression screening of clients at a hospital-based outpatient behavioral health clinic. Purpose and Objectives: Implementation of the PHQ-9 into the clinic’s mental health assessment process to increase …

Improving A Discharge Process To Decrease Readmission Rates, Erni Ensing

Master's Projects

No abstract provided.

The Effect Of Exercise On Symptoms Of Depression In Adults Diagnosed With Clinical Depression: An Integrative Literature Review, Tibil Felix

Grace Peterson Nursing Research Colloquium

Background: While many healthcare providers are currently looking for alternative methods such as exercise to treat depression, there are limited studies to report how exercise effects symptoms of depression in adults diagnosed with clinical depression and whether an ideal exercise prescription exists.

Objective: The purpose of this integrative literature review was to evaluate the effect of exercise on adults with clinical depression.

Method: An integrative literature review was used. The tidal model of mental health as proposed by Dr. Phil Barker and Poppy Buchanan-Barker was used as a basis for this review. The keywords “clinical depression, exercise, adults, depression treatments, …

Barriers To Providing Psychiatric Care Within Cook County Public Health System: An Integrative Literature Review, Elizabeth Ann Reuter

Grace Peterson Nursing Research Colloquium

Abstract

Background: Cook County Public Health Systems located in Cook County, Illinois, are responsible for providing free and low cost psychiatric care to thousands of residents despite continuing state and federal budget cuts and inadequate Medicaid reimbursements. This not only financially strains county taxpayers, but it also limits treatment options, negatively impacts patients, and places an extreme burden on the public service workforce.

Objectives: The purpose of this integrative literature review was to identify the major barriers of providing psychiatric care within Cook County Public Health Systems.

Method: An integrative literature review was conductedusing the databases of Academic Search …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Stop, Meditate, And Listen: A Treatment Modality For Iraqi Refugees With Depression, Katherine Goehring

Doctor of Nursing Practice Final Manuscripts

Purposes: To implement a mindfulness meditation program with Arabic speaking clients as an adjunctive treatment of depression

Background: Depression rates among Iraqi refugees are between 28.3 and 75% compared to 8.6% in the general population (Slewa-Younan, Guajardo, Heriseanu, & Hasan, 2015). Treatment options are limited at Neighborhood Healthcare in El Cajon due to budget limitations, cultural beliefs and language barriers, among other reasons. Individual therapy is intended to be a brief intervention due to limited staffing. Many middle eastern refugees decline group therapy due to stigma surrounding mental health treatment and concerns about privacy. Even though traditional treatment …

Metabolic Syndrome Screening Among Inpatient Psychiatric Patients, Susan Magorno

Doctor of Nursing Practice Final Manuscripts

Background: More than 50% of patients with severe mental illness carry undiagnosed Metabolic Syndrome (MetS) comorbidities of hypertension, hyperlipidemia, or diabetes. These patients are three times more likely to die of cardiovascular-related causes; however, this population is not routinely assessed for MetS and frequently lack appropriate treatment.

Objective: The objective is to implement a screening tool designed to identify risk for MetS and trigger appropriate treatment.

Design: The screening tool triggers the provider to address positive criteria through interventions such as further evaluation, medical and/or diabetes educator consultation.

Results: Although overall rates of screening improved significantly, follow-up interventions were …

Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller

Master's Theses

This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …

Watson’S Theory Of Human Caring: Effect On Nurse Perception Of Care Environment, Shannon Jones

Nursing Theses and Capstone Projects

Psychiatric and mental health nurses face unique problems related to the specifics of the role including low morale and burnout. These problems stem from many factors including insufficient staffing, lack of support from management, and patient behaviors such as aggression or noncompliance which lead to poor patient outcomes. The purpose of this study was to determine what effect adoption of Dr. Jean Watson’s Theory of Human Caring has on nurse perception of the care environment on an inpatient psychiatric unit in a rural community hospital as measured by a modified version of the Combined Assessment of Psychiatric Environments (CAPE) instrument. …

Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott

Doctor of Nursing Practice Scholarly Projects

The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …

Pornography As A Public Health Issue: Promoting Violence And Exploitation Of Children, Youth, And Adults, Elisabeth Taylor

Dignity: A Journal of Analysis of Exploitation and Violence

The pornography industry is expanding exponentially as a result of ongoing technological advances. The ability to stream videos over the internet and the ubiquity of the smart phone have meant that pornography producers are able to use algorithms to target potential consumers, to cultivate new sexual tastes and to deliver content to a more diverse audience over mobile devices. The advent of virtual reality pornography with interactive sex toys and sex robots imbued with artificial intelligence promises to unleash a further step-change in the extent to which pornography influences ‘real-world’ sexual culture. The critical analysis of pornography undertaken over decades …

Maternal Psychological Distress And Cortsiol, Jenna Schroeder

Grace Peterson Nursing Research Colloquium

Abstract

Background: Previous studies have reported associations between prenatal maternal distress and negative health outcomes for the unborn. There are gaps within this body of knowledge and inconsistencies in the research which make the relevant relationships unclear. If changes in maternal cortisol cause alterations in fetal development, it is important to gain an adequate understanding of how, and if, maternal psychological distress predicts maternal cortisol levels. This study is an integrative literature review that looks at the research investigating a connection between maternal psychological distress and maternal cortisol levels during pregnancy. Lazarus and Folkman’s (1984) Transactional Model of Stress and …

Prevention Of Post Intensive Care Syndrome-Family With Sensation Awareness Focused Training Intervention: A Randomized Controlled Trial Pilot Study, Paula L. Cairns

USF Tampa Graduate Theses and Dissertations

Post Intensive Care Syndrome-Family (PICS-F) refers to acute and chronic psychological effects of critical illness on family members of patients in intensive care units (ICU). Evidence about the increase and persistence of PICS-F warrants the need for prevention interventions. This study evaluated the feasibility of providing Sensation Awareness Focused Training (SĀF-T) during the ICU stay for spouses of mechanically ventilated patients. Methods: A randomized controlled trial of SĀF-T versus a control group was conducted (n=10) to assess safety, acceptability, feasibility, and effect size of the intervention on PICS-F symptoms. Symptoms assessed as outcome measures included stress, anxiety, depression, posttraumatic stress …

Conversion Disorder, Ann Summar

Nursing Posters

Conversion Disorder:

• Neurologic symptoms that are inconsistent with a neurologic disease
• Symptoms cause distress and/or impairment
• No radiological or laboratory findings for symptoms
• May have poor outcomes without proper treatment

The Impact Of Schizophrenia On Copd Readmission Rate Among Hospitalized South Carolinians, Emilienne Y. Watonsi

DNP Research Projects

Due to elevated readmission costs, the Affordable Care Act established the Hospital Readmission Reduction Program in 2012 to curb the 30-day readmission rates. COPD and schizophrenia are two very expensive diseases, COPD national medical costs is projected to be $49.0 billion in 2020; the cost of schizophrenia was 155.7 billion in 2013. The main objective of this study was to determine if schizophrenia is a significant predictor of 30-day readmission following hospitalization for acute exacerbation of COPD after adjusting for age, gender, anxiety, smoking status, T2DM, chronic ischemic heart disease, and GERD. Methods: A retrospective cohort design was used to …

Best Practices For Screening, Identification, And Referral Of Female Collegiate Athletes With Disordered Eating, Brenda Caudill

Doctor of Nursing Practice Projects

Eating disorders have the highest mortality rate of any mental illness, including depression. Female collegiate athletes are at greater risk compared to the non-athlete population. Athletic personnel should be prepared to screen, identify, and refer female athletes for eating disorders. However, most staff are not familiar with common signs and symptoms of disordered eating, which could delay recognition of unhealthy behavior and ultimately long-term health risks. Appropriate screening protocols can assist with early identification. The purpose of this DNP project was improve the knowledge of the athletic staff regarding eating disorder recognition, awareness of university policy for identification and referral …

The Lived Experiences Of Opioid Withdrawal: A Phenomenological Study, Eliza Mall

DNP Research Projects

The United States is in the midst of an opioid overdose epidemic resulting to 40,000 accidental drug overdose deaths. In 2016, the number of deaths related to opioid overdose increased to 116 people per day resulting to $504 billion in economic costs. This research study explored the lived experiences of drug addicts having experienced opioid withdrawal symptoms. Phenomenology is useful in discovering the narrative lived experiences that cannot be obtained in quantitative approach. Six themes emerged to describe the lived experiences of opioid addicts who have undergone withdrawal: (a) Increasing desires that are hard to resist (b) Helplessness and hopelessness …

Stress, Anxiety, And Depression: Role Of Campus Connectedness, Social Support, And Coping Among Nepalese Nursing Students, Priscilla Samson

Walden Dissertations and Doctoral Studies

High levels of stress, anxiety, and depression (SAD) can adversely influence physical health, psychological well-being, and academic and clinical performance of nursing students. Numerous studies have identified the factors associated with SAD; however, a paucity of empirical research addresses the relationship of SAD with campus connectedness (CC), perceived social support (PSS), and coping. The purpose of this quantitative cross-sectional study, guided by Lazarus and Folkman's theory of stress, coping, and adaptation, was to determine the prevalence of SAD and examine its relationship with CC, PSS, and coping among undergraduate nursing students of Nepal. Survey research was conducted using depression anxiety …

Assessment Of The Need For Provider Education On Screening For Depression In Patients With Select Dermatologic Problems, Sarah B. Zerhusen

DNP Projects

PURPOSE: The purpose of this project is to evaluate the knowledge, attitudes, perceptions, skills, and self-efficacy of dermatology providers’ assessment of depression in patients with chronic skin disease to determine the need for continuing education programs.

METHODS: This is a single practice, multi site, quantitative correlational design study to assess provider use, comfort, and proficiency of screening and discussion of depression in patients suffering from plaque psoriasis and atopic dermatitis. Data was collected through the use of a questionnaire dispensed in January of 2018. The sample consisted of 23 dermatology providers in a dermatology practice with clinics in Louisville, Lebanon, …

Improving Adherence To Mental Health Treatment In A Low-Income Clinic, Janice G. Gandy

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The increasing prevalence of mental illness in the United States presents significant challenges for primary care providers in low-income settings. Integrated Behavioral Health (IBH) programs have resulted in improved general health for low-income participants; however, managing appointment adherence, in which the patient attends appointment as scheduled, is particularly challenging. The purpose of this pilot project was to implement bundled interventions at a low-income primary care clinic to improve patient adherence to behavioral health treatment. The bundle of interventions included: 1) educational interventions emphasizing the benefits of IBH care 2) warm patient handoffs between the primary care provider to a behavioral …

Effectiveness Of An Open Access Scheduling System In A Community Mental Health Center, Callie Crockett

Doctoral Projects

Abstract

Open Access Schedule (OAS) systems are a new way to schedule patient appointment in an outpatient medical setting. In theory these systems will provide many benefits that are not seen in a traditional scheduling model, such as decreased wait times to see a provider and more provider flexibility. However, little research has been done to examine how effective these systems are once they are put into practice, particularly in the mental health setting. The purpose of this project was to examine a recently implemented open access scheduling system in a community mental health center in rural Northeast Tennessee and …

Increasing Depression Screenings In Adults With Advanced Non-Surgical Heart Failure Using 2013 Accf/Aha Recommendations And Healthy People 2020 Target Goals, Valerie Valencia

Doctor of Nursing Practice

The purpose of this evidence-based practice project was to increase depression screenings in adults with non-surgical advanced heart failure using reliable and valid tools, 2013 American College of Cardiology Foundation/American Heart Association recommendations, and Healthy People 2020 Target Goals as a method to identify and facilitate appropriate mental health referral, patient education, and follow-up for depressive symptoms. Interventions took place June 5, 2017, through August 10, 2017. This intervention project involving 246 adults with advanced heart failure demonstrated that an evidence-based intervention for depression screenings increased the number of patients screened from 5% to 44%. At project completion, 65% of …

Grace Peterson Research Colloquium, Emma Pfeiffer

Grace Peterson Nursing Research Colloquium

Mental illness is commonly under-diagnosed, misdiagnosed, or untreated, particularly in the elderly population. An expected population increase for those 65 years and older, increased in health care expenses coupled with the moral and ethical obligation of health care providers to promote quality of life at all ages makes investigation to alternative treatments in this population is worth investigating. The purpose of this literature review is to synthesize existing studies to clarify the following questions: What are the effects of pet therapy on those experiencing signs and symptoms of depression and anxiety? Why is pet therapy still lagging in validated studies, …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …