Nursing Commons^™

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

Implementation Of A Mental Health Environmental Risk Assessment Tool, Alan Le

Doctor of Nursing Practice (DNP) Projects

Background: Patient suicide is a serious safety issue, especially in mental health settings since suicides disproportionately affect psychiatric patients. Environmental hazards are a primary contributing factor in patient suicide cases.

Problem: Mental health staff may lack tools and training to perform proper environmental risk assessments, which is the case at a psychiatric crisis residential center in northern California that utilized no environmental risk assessment tool.

Methods: An environmental risk assessment tool was implemented at the site for four months to increase staff confidence, ability to identify hazards and decrease risk of patient suicides.

Interventions: The Suicide and …

Optimizing Postpartum Care By Ongoing Care Coordination Initiatives (Cci) In Screening And Management Of Postpartum Depression (Ppd) Among Clients In An Obgyn Practice: A Quality Improvement Project., Jennifer Broussard

Doctor of Nursing Practice (DNP) Manuscripts

Background: Postpartum depression (PPD) is defined as physical, emotional, and behavioral changes that occur after the birth of a child. Postpartum depression is complex and a mix of physical, emotional, and behavioral changes (Cleveland Medical Clinic, 2018). Postpartum depression screening is of high importance at a comprehensive postpartum visit. The consequences of a patient suffering postpartum depression can be serious and early recognition and interventions improve outcomes for the patient as well as the infant. Problem: There is a lack of screening for PPD among postpartum clients and this period is critical for the mother and the infant (American College …

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …

Student Pharmacists’ Emotional Responses And Coping During The Covid-19 Pandemic, Hannah E. Johnson, Deaundre Bumpass, Aric Schadler, Jeffrey Cain

Journal of Wellness

Introduction: Health professions students, including student pharmacists, have been impacted by the coronavirus disease 19 (COVID-19 pandemic) as schools have transitioned to remote learning and cancelled milestone events. During times of crises, media consumption and hobby participation also impact well-being. The adverse emotional responses and coping strategies of student pharmacists amidst the COVID-19 pandemic have not been evaluated, nor have factors that may contribute to emotional responses. The purpose of this study is to determine Doctor of Pharmacy students’ emotional responses and coping precipitated by the COVID-19 pandemic, and the influence of media use, working status, and participation in hobbies. …

Bullying In The C-Suite: A Nurse Leader Perspective, Kimberly Ann Colonnelli

Doctor of Nursing Practice (DNP) Projects

An estimated 35% of American workers have experienced bullying, and in 80% of those situations, the perpetrator was a supervisor or boss. 1 However, the reality is that bullying can come from anyone in the workplace, including subordinates. Victims are generally well liked and good performers, making them feel like threats to a bully’s power base. Bullying, unlike harassment, is not a legally defined behavior, so no laws currently exist to punish it. Victims are, therefore, at the mercy of their bosses, supervisors, co-workers, and human resource departments for protection or relief. Bullying is not a singular event, but rather …

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Bridging Mental Healthcare, Kristin L. White

MSN Capstone Projects

Nurses have an important role in the care given to mental health patients presenting to the emergency department (ED). Without expectations or encouragement toward growth or continued education, the quality of care and the therapeutic ability for care are crippled, as evidenced by nurses' knowledge/competency deficits and negative attitudes. Through ongoing/continued education, the cultivation of a therapeutic culture toward patients that present to the ED for mental health complaints could result. Additionally, these improvements in care, in turn, could promote not only the closure of gaps that exist for quality mental healthcare but may also lead to an increase in …

Deterring Delirium In The Intensive Care Unit, Kimberly Allen

MSN Capstone Projects

There is growing concern about the increase in cases of delirium associated with a critical care hospitalization encounter. Discovery of different types of research that can eliminate or at least minimize occurrences of delirium including early recognition, eye masks and earplug usage, and environmental changes have show promise in reducing the risk of ICU delirium.

Burnout Among Intensive Care Nurses, Julia Brown

MSN Capstone Projects

At a time when the healthcare system is experiencing strain due to the current health crisis and nursing shortages, talking about, and addressing nursing mental health is of the utmost importance. Nurses who work in the pediatric intensive care unit (PICU) often face more stress due to the patient population they work with. These stresses can lead to burnout and moral distress if not addressed appropriately. Nurses should have a system in place at their workplace and tools readily available to support their mental health while on the job. Through a literature search, it is proposed that an initiation of …

Implementing Evidence-Based Treatment Of Patients With Opioid Use Disorder In An Inpatient Addiction Treatment Center, Emily Ashley

Doctor of Nursing Practice

Patients with opioid use disorder are at increased risk for overdose and death should they relapse due to reduced opioid tolerance after a period of abstinence. A retrospective chart review was performed at an inpatient drug and alcohol treatment center to identify areas in need of improvement. The global aim of this project was to promote patient adherence to treatment, as well as increase the prevention of patient overdose and death after inpatient treatment. Project objectives include improving provider management of opioid use disorder through standardizing patient education, increasing prescription of relapse prevention medication, initiating prescription of naloxone at discharge …

Effects Of Abstinence-Based Sexual Education Compared To Evidence-Based Sexual Education In K-12 Schools, Lily Probst

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Historically, sexual education in the United States has been abstinence-based (ABSE), meaning that sexual education is centered around encouraging adolescents to abstain from sexual activity outside of wedlock. On the other hand, evidence-based sexual education (EBSE) includes abstinence in its curriculum but does not emphasize it, instead highlighting contraception and prevention strategies. Additionally, EBSE teaches adolescents about healthy relationships, attitudes towards sexuality, gender roles, and provides resources for sexual and reproductive health services. Supplying adolescents in K-12 schools with access to evidence-based sexual education may not only decrease teen pregnancy rates and incidence of sexually transmitted infections (STIs) but …

Implementation Of An Interprofessional Fall Prevention Program To Reduce Falls On An Older Adult Inpatient Psychiatric Unit, Teresa Woodson

Doctor of Nursing Practice

Background. Falls are the most reported incidents in the hospital setting, especially among older adults. According to the National Database of Nursing Quality Indicators (NDNQI), the number of falls in inpatient psychiatric units is 13-25 per 1,000 patient days, compared to 4 per 1,000 days for medical-surgical units. This DNP project aims to implement an interprofessional fall risk team to reduce falls in an older adult inpatient psychiatric unit. Problem. The psychiatric inpatient units had a total of 31 falls, with 13 (40%) occurring on the older adult unit. Interventions. Education of nursing staff, providers, and physical therapy (PT) …

Implementing An Evidence-Based Practice Change For Alcohol Withdrawal In An Acute Care Hospital, Theresa Carroll

Student Scholarly Projects

Practice Problem: Alcohol Use Disorders (AUD) affects a significant portion of the population in the United States. When AUD is either unrecognized or inadequately treated in the acute care setting it can lead to medical complications, increased length or stay (LOS), increased healthcare expense, and increased patient mortality.

PICOT: In a population of adult patients admitted to an acute care hospital progressive care unit (P), how does applying an initial evidence-based screening tool to detect risk for moderate to severe alcohol withdrawal, the PAWSS (I), compare to no standard screening or assessment for potential alcohol withdrawal symptoms (C) affect the …

Case Study--Jimmy (Zero Balancing And Cst), Judith Sullivan

Journal of Transformative Touch

Jimmy started receiving Zero Balancing and CranioSacral Therapy when he was 11 months old for significant torticollis and scoliosis. In 7 sessions between the beginning of November and the beginning of February. His x-rays show changes within normal ranges.

Reducing Burnout Through Guaranteed Breaks In Nurses In The Acute Care Setting: A Benchmark Study, Stefan D. Arias

MSN Capstone Projects

This benchmark study attempts to promulgate the issue of burnout and the importance of addressing at least one way to mitigate further damage to the profession of nursing.

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 …

Rebuilding A Foundation Of Trust: A Call To Action In Creating A Safe Environment For Everyone, Cynda H. Rushton, Laura J. Wood, Karen Grimley, Jerry Mansfield, Barbara Jacobs, Jason A. Wolf

Patient Experience Journal

Well before the COVID-19 pandemic, incivility and physical threats directed toward healthcare employees and often registered nurses was a growing concern by Chief Nurse Executive (CNE) leaders. In 2019, conversations initiated by The Beryl Institute’s Nurse Executive Council (NEC) to consider how best to achieve a much-needed balance between patient/family and staff safety have now become a critical priority to ensure the safety of everyone receiving and providing health care services. The heart of this work was organized around a set of newly developed ethical precepts designed to guide the exploration of key concepts. A call to action grounded in …

Opioid Use Disorder: A Crisis Of Concern, Evangella Harville

Electronic Theses and Dissertations

According to a statement from the U.S. Centers for Disease Control and Prevention, between 2000 and 2017, approximately 700,000 people died from drug overdoses in the United States. Approximately 128 persons lose their life each day from an opioid overdose. The data for this study were collected by the vice president of operations at the study site from a preexisting database for 2019 and 2020. The participants were inpatient patients, 18 and older, both male and female, and were from all ethnicities. The study facility was located in Western New York and offered a 30-bed inpatient treatment center with 24-hour …

The Effect Of Maternal Traumatic Life Events And Social Support On Maternal-Child Interaction At Child Age 3 Years, Sandra I. Madubuonwu

Theses and Dissertations (ETD)

Introduction: Becoming a parent is a very important role and responsibility in people’s lives and knowing the role traumatic life events (TLEs) may play on a mother-child relationship is a very important area to explore. TLEs are known to have adverse effect on individuals; however, little is known regarding the effect of maternal TLEs on maternal-child interaction. Social support has been known to positively affect the overall wellbeing of individuals, but little is known about the effect of social support on mothers who experienced TLEs and interaction with their children thus the need for this study. This study examines the …

Benzodiazepine Reduction Program In A Psychiatric Mental Health Setting, Tracy Pacini

Dissertations

Benzodiazepine Reduction Program in a Psychiatric Mental Health Setting

The purpose of this pilot project was to reduce side effects and adverse effects of long-term benzodiazepines (BZDs) use in a non-profit community health center. This was a quality improvement project. The evidence-based practice (EBP) framework identified for the project was from the Institute for Healthcare Improvement (IHI) Plan-Do-Study-Act (PDSA) framework to decrease BZD use in a non-profit community health center. This model is focused on four stages: 1) gathering a proactive healthcare team to examine and identify solutions to reduce BZD usage, 2) testing the pilot program that the team …

Zero Balancing: Conscious Touch And Transformation Book Review, Misty L. Rhoads

Journal of Transformative Touch

Zero Balancing: Conscious Touch and Transformation by pioneering transformative touch practitioner and teacher James McCormick is a profound and engaging textbook that teaches readers a multi-layered approach to working with the body, mind, and spirit through skilled, conscious touch.

Implementing Interventions To Improve Care For Perinatal Mothers With Substance Use Exposure, Katrina Munoz, Bsn, Rn, Rnc-Mnn, Le

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

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 …

Shu Altop News Issue #4, Fall, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

Updates from the Davis & Henley College of Nursing Sacred Heart University Alternatives to Opioids for Pain Grant.

Alternatives to Opioids for Pain (ALTOP) is a HRSA funded project to help combat the opioid epidemic in Connecticut.

In this issue: • New Roles in Our Team • ANEW HRSA 2021-2022 Awardees • Southwest Community Health Center Chiropractic Care Services • Student Quality Improvement Project • Sacred Heart University Alumni Working at New Solutions Pain Management Clinic.

The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook

Electronic Theses and Dissertations

Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …

Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd

Electronic Theses and Dissertations

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …

An Evaluation Of An Integrated Multidisciplinary Early Identification And Triage Of College Students At Risk For Anxiety And Depression, Sarah J. Templeton

Electronic Theses and Dissertations

College students across the U.S. are experiencing an increasing prevalence of mental health concerns, such as anxiety and depression. Suicide is currently the second most common cause of death among U.S. college students. At the project site, the university health services report that mental health issues significantly impact the students’ academic progress, contributing to poor performance, inability to complete assignments, and sometimes forces attrition. Campus providers traditionally respond when students approach, often at the point of crisis or exacerbation. This Doctor of Nursing Practice (DNP) project evaluated the impact of a pilot program using an interdisciplinary approach to universal proactive …

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

Utilizing Digital Technology To Address Loneliness And Isolation In Older Adults Through A Community-Based Connection Model: Responding To A Pandemic, Melissa A. Nagel

Doctor of Nursing Practice (DNP) Projects

Problem: Loneliness and social isolation, both of which can have serious detrimental effects on health and well-being, have become more prevalent during the recent COVID-19 pandemic, particularly in the older adult population. During part of the past year, older adults were strongly encouraged to follow strict quarantine measures because of their vulnerability to the virus. This forced isolation exacerbated the already existing issue of loneliness and social isolation in this population.

Interventions: Older adults who are members of a local non-profit community organization, focused on increasing independence and social vitality, were invited to participate in a virtual, interactive social engagement …