Psychiatric and Mental Health Commons^™

The Impact Of High Deductible Health Plans On Mental Health Treatment, Kristian D. Dambrino, Laura Gray, R. David Phillippi

DNP Projects

Background and Rationale: High Deductible Health Plans (HDHPs) are designed to reduce overall healthcare spending by shifting more upfront costs to patients to discourage overutilization of care, yet HDHPs often increase financial burden, particularly in outpatient mental health care. Patients covered by HDHPs often face substantial out-of-pocket costs before reaching their deductible. This can lead to potential delays or discontinuation of psychiatric treatment. Financial transparency interventions by the mental health provider may mitigate these barriers through more-informed patient decision-making regarding payment options. This project evaluates the impact of a financial transparency intervention on reducing payment responsibility for HDHP patients in …

Evaluating Preoperative Care Providers' Perceptions Of The Autism Support Checklist For Surgical Patients With Autism Spectrum Disorder, Amanda Hancock

DNP Projects

Abstract

Background: Individuals with autism spectrum disorder (ASD) are more likely to report barriers to healthcare access than individuals with other disabilities and non-autistic persons. Many barriers to healthcare for those on the spectrum have been identified and include: negative interactions with healthcare staff, communication barriers with healthcare providers, lack of providers knowledgeable of ASD, sensory concerns, and difficulty navigating the healthcare system. The Autism Support Checklist (ASC) is a tool designed to outline communication methods, sensory concerns, soothing items/actions, triggers, special interests, safety concerns, and other information pertinent to an autistic patient. The tool is designed to convey the …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

The Effect Of A Community Resiliency Model Education On Resilience, Psychological Empowerment, And Well-Being In Behavioral Health Nurses, Lorrie Smith-Esterle

DNP Projects

Background: Resilience, well-being, and psychological empowerment are associated with improvement in job satisfaction and nurse retention rates. The Community Resiliency Model (CRM) can promote emotional regulation, well-being, and create an internal state of balance in response to work-related stressors. Educating nurses on how to use CRM enables the recognition of changes in thoughts, emotions, sensations, and internal or external stimuli, which can promote resilience, well-being, and psychological empowerment.

Purpose: The purpose of this project was to evaluate evaluate the effect of a resiliency education using the Community Resiliency Model (CRM) on resilience, psychological empowerment, and well-being of behavioral health nurses. …

Implementation Of A Death Anxiety Screening Protocol Specific To Patients With Advanced Cancer In An Outpatient Palliative Care Setting, Olivia M. Sasdi

DNP Projects

Abstract

Background: Recent studies have shown that upwards of 80% of patients with advanced cancer suffer from death anxiety resulting in increased physical and psychological suffering. Despite death anxiety’s ubiquitous nature and negative impact, the literature regarding this condition consistently indicates that it remains under-identified and undertreated in patients with advanced cancer. The “Death and Dying Distress Scale” (DADDS) is a clinically validated tool used to identify, measure, and guide effective treatment modalities for death anxiety specifically in patients with advanced cancer, but is scarcely used routinely in practice. Incorporating this screening tool to be used regularly could improve identification …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

Screening For Severe Mental Illness In A Correctional Setting Using The Brief Jail Mental Health Screening Tool, Stephanie Kohl

DNP Projects

Abstract

BACKGROUND: Prisoners who are detained in jails and detention centers have higher rates of Severe Mental Illness (SMI) compared to the general population. However, SMI is often unidentified in this population, largely due to lack of assessment using effective SMI screening tools and lack of knowledge among prison staff about the prevalence of SMI and the importance of identification in the correctional setting. Prisoners with SMI often act out violently against others and themselves. Current standard practice for SMI screening varies significantly across jails. Many jails use standard medical questionnaires which help obtain a brief medical history but often …

The Effect Of Education On The Nida Modified Assist (Nmassist) Tool On Knowledge And Screening For Substance Use Disorder Among Clinicians, Victoria Page Arnold

DNP Projects

Background: Substance use disorder (SUD) is a disparity affecting nearly 24 million individuals in the U.S., nearly 10% of the total population. Oftentimes, the emergency department (ED) is the only medical care this population receives. There is often a lack of screening for SUD in ED’s, therefore referred care may be limited for these individuals. The National Institute on Drug Abuse Modified Assist (NMASSIST) is an evidence-based tool developed to educate and screen for SUD. This tool can be completed in a timely manner and aid in the recommended referral of care for this select population.

Purpose: The purpose of …

Evaluation Of Middle School Teachers Knowledge, Attitudes, And Barriers Pertaining To Adapted Youth Mental Health First Aid For Middle School Students, Lauren Hurley

DNP Projects

Background: An estimated 17.1 million youth have experienced a mental health disorder, more than the number of children with cancer, diabetes, and AIDS combined (National Council for Behavioral Health, 2016). Unfortunately, of those children with a diagnosable condition, only a third receive mental health treatment (National Council for Behavioral Health, 2016). If a child or adolescent’s mental health disorder is left untreated, then unresolved issues may continue to affect them as adults, creating physical and mental health impairments, that could potentially have a negative impact on their futures. Youth Mental Health First Aid (YMHFA) is an evidenced-based training program that …

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 …

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 …

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 …

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, …

Evaluating The Relationship Between Phq9 And Global Pain Scale (Gps) Scores In Opioid Dependent Adults: A Retrospective Correlational Study, Lori Nolan

DNP Projects

Background: Depression, chronic pain and opioid dependence are conditions commonly encountered in primary care settings. These comorbidities create treatment challenges while negatively influencing outcomes of care. The Patient Health Questionnaire (PHQ9) and Global Pain Scale (GPS) are valid screening tools used to score depression and pain symptoms. The purpose of this study was to determine the relationship between the PHQ9 and Global Pain Scale (GPS) scores in opioid dependent adults with chronic pain to determine whether both tools are necessary.

Methods: This was a descriptive study using a retrospective correlational research design. Data was obtained from the electronic medical records …

Screening For Alcohol Use/Abuse In The Primary Care Setting Using The Audit-C And Sbirt (Screening, Brief Intervention, Referral To Treatment), Whitney D. Spear

DNP Projects

PURPOSE: The purpose of this study was to examine the feasibility of alcohol screening in the primary care setting to detect alcohol abuse or misuse using the AUDIT-C standardized screening tool and SBIRT.

METHODS: This study design was a Quasi-Experimental intervention, one group post-test. Data was collected via retrospective chart review from the electronic medical records by the type of office visit; either new patient initial visit or annual well visit. The patient sample consisted of 25 participants for the study period of September 19^th through October 10^th, 2017.

RESULTS: There were 37 patients eligible to participate …

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Foster Parents' Perceptions And Beliefs About Social Emotional Development In Infants And Toddlers, Susan R. Noel

DNP Projects

Infants and toddlers placed in foster care are at increased risk for social-emotional (SE) development dysregulation. Foster parents, as surrogate parents, play a critical role in a young child having the potential for healthy SE development. The transactional model supports the complex and intricate interplays and transactions of the child, the foster parent, and the environment that influences a healthy SE development. This qualitative descriptive study explored foster parent knowledge, behavioral cue recognitions, and role perception regarding a young child's SE development. Although the sample size was small, the study provides relevant information, from the on-going experiences of foster parents, …

Implementation Of A Depression Screening Protocol Specific To Implantable Cardioverter Defibrillator Patients; A Quality Improvement Project, Kendra M. Kratzwald

DNP Projects

Background: Depression in patients with implantable cardioverter defibrillators (ICD) is a problem that has not been well addressed by providers. In 2012 the American Heart Association (AHA) released a scientific statement that recommended structured and routine depression screening of these patients. The AHA statement also recommended further research on depression screening instruments and their use with this population. Aims: 1.) To develop and implement an evidenced based depression screening protocol appropriate for patients with an ICD seen in an outpatient setting. 2.) Evaluate provider knowledge about depression screening (? Is this what you mean) and depression screening practices before and …