Nursing Commons^™

Improving Access To Mental Health Care Using Telehealth, Lavern Palmer

Doctor of Nursing Practice Projects

More than half of adults with mental illness in the United States live in mental health deserts—geographic areas with limited access to mental health services and persistent barriers to care. This study investigates the impact of telehealth implementation on patient no-show rates at a rural community clinic in Georgia. The aim was to determine whether the use of telehealth for psychiatric care would decrease the no-show rate of mental health appointments. A retrospective analysis was conducted using patient attendance logs collected 12 weeks before and after the implementation of telehealth services. Quantitative data were analyzed using a Pearson correlation to …

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 …

Factors Associated With Quality Of Intrapartum Care In Kenya: A Complex Samples Analysis Of The 2022 Kenya Demographic And Health Survey, Lilian Nuwabaine, Earnest Amwiine, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Angella Namulema, Ahmed Sarki, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Background

The provision of quality intrapartum care increases women’s utilization of skilled birth attendants in health facilities and improves maternal and newborn health. This study aimed to investigate the factors associated with the quality of intrapartum care using the 2022 Kenya Demographic and Health Survey (KDHS).

Methods

Secondary data from the 2022 KDHS of 11,863 participants, who were selected by multistage stratified sampling, was used. Based on literature and the availability of indicators within the 2022 KDHS, the quality of intrapartum care was operationalized as receiving all the three clinical components of intrapartum care including a mother having a facility-based …

Perinatal Mood And Anxiety Disorders (Pmads): A Scoping Review, Christina Willis Bsn, Rn, Nia Wells Bsn, Rn, Miranda Smith Bsn, Rn, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background Perinatal Mood and Anxiety Disorders (PMADs), including postpartum depression, anxiety, and psychosis, significantly impact maternal and infant health. This scoping review consolidates current literature on PMADs, emphasizing prevalence, risk factors, screening, and treatment. The primary aim is to identify research gaps and inform clinical guidelines to enhance perinatal care.

Methods A literature search followed PRISMA guidelines from August 2022 to November 2024. Databases searched included PubMed, CINAHL, Scopus, and Google Scholar, using terms such as "perinatal mood disorders" and "maternal mental health." Inclusion criteria were English-language studies from the past decade addressing PMADs during pregnancy and up to one …

Evaluating The Effectiveness Of A Non-Pharmacological Sleep Bundle For The Prevention Of Delirium In Geriatric Patients In The Intensive Care Unit: A Scoping Review, Morgan Wilkins Bsn, Rn, Vanessa D'Amico Bsn, Rn, Alyssa Goyda Bsn, Rn, Seema Janga Bsn, Rn, Kaylin Story Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is an acute disorder yielding cognitive deficits, such as disruption in attention and awareness. It impacts approximately 50% of individuals over the age of 65 who are admitted to the hospital and is prevalent with patients in the intensive care unit (ICU). ICU delirium is associated with adverse outcomes, including higher morbidity, prolonged hospital stays, and chronic neurocognitive deficits. Research demonstrates that implementation of a non-pharmacological sleep bundle can reduce the overall occurrence of delirium. The purpose of this scoping review is to examine the efficacy of a non-pharmacological sleep bundle on the incidence of ICU delirium in …

Supporting Maternal Mental Health In The Postpartum Period With The Use Of Home Resource Kit, Nicole Craig

Theses and Graduate Projects

Postpartum mental health disorders, including postpartum depression and anxiety, can affect a significant proportion of new mothers for centuries. This paper explores the development, implementation, and evaluation of an at-home mental health resource kit designed to support maternal mental health while navigating the stresses of new motherhood. Utilizing Jean Watson's Theory of Human Caring as a theoretical framework, the study assesses the effectiveness of integrative therapies such as aromatherapy, mindful meditation, and educational resources in managing postpartum stress. Data collected through pre- and post-surveys and roundtable discussions provide insights into the benefits and limitations of these interventions. The findings indicate …

The Effectiveness Of Gad-7 Screening In High School Students, Tamara L. Smith, Allison Darnell, Margaret Harvey, Phd, Acnp-Bc, Chfn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Adolescent mental health is a growing concern, with anxiety disorders being particularly prevalent among high school students. Left untreated, anxiety can significantly impact academic performance, social functioning, and long-term mental health. The COVID-19 pandemic exacerbated these challenges, highlighting the critical need for effective screening and intervention strategies. The Generalized Anxiety Disorder 7-item scale (GAD-7) is a validated tool for identifying anxiety disorders, yet its application in high school settings is limited. This scoping review explores the effectiveness of GAD-7 in increasing mental health referrals and improving anxiety outcomes in high school students.

Methods

A comprehensive search was conducted across …

The Impact Of Covid-19 On Nurses' Feelings, Stress, Coping, And Motivation In Palestinian Treatment Centers Of Corona, † Wafaa Menawi, Shatha Mari, Ahmad Adel Hanani

An-Najah University Journal for Research - B (Humanities)

Background: Frontline nurses of COVID-19 found themselves in an unfamiliar new disease work environment, fighting to adapt and control the stress while working at covid-19 centers in Palestine. Aim: To investigate the impact of COVID-19 on nurses' feelings, stress, coping, and motivation in COVID-19 Palestinian treatment Centers. Method: A descriptive cross-sectional design was conducted between Mid of July to the end of October 2021 by recruiting a purposive sample of 390 nurses who worked at the Ministry of Health during COVID-19 pandemic treatment centers. The nurses filled out the COVID-19 Health Personnel Questionnaire with Cronbach's Alpha > 0.9. Results: Palestinian frontline …

Evaluating The Efficacy Of Predischarge Referrals In Preventing Emergency Mental Health Hospital Readmissions: A Scoping Review, Pretia Carpenter Bsn, Rn, Stephanie Mays Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon H. Little, Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Background

Emergency mental health hospital readmissions present significant challenges to healthcare systems, often resulting in increased costs, prolonged hospital stays, and poor patient outcomes. Continuity of care through predischarge referrals to outpatient mental health services, psychosocial support, and community resources has been proposed as a strategy to reduce readmissions. However, the effectiveness of these interventions remains inconsistent across different populations and settings.

Objective

This scoping review aims to evaluate the effectiveness of predischarge referrals in reducing 30-day emergency mental health hospital readmissions, identify key components of successful programs, and assess the influence of demographic factors on readmission rates.

Methods

A …

Integrating Workplace Violence Prevention Into Nursing Curriculum: Preparing Future Nurses For Safer Practice ​, Noah Briere, Sarah Kegerreis, Molly Lasyone, Savannah Orris

SPARK Symposium Presentations

Nurses are under attack. 80% of nurses have experienced some form of workplace violence (WPV), which is seen as “part of the job.” Unfortunately, the agency responsible for protecting nurses, the Occupational Safety and Health Administration (OSHA), only offers voluntary guidelines. We have determined that nursing students are the best group to educate about WPV prevention in healthcare. Including this teaching to fit within their pre-clinical requirements, only needing one faculty to teach with an average salary of $80k, to further help set what should be foundational skills. By adding WPV de-escalation techniques and adequately preparing students prior to graduation. …

Combating Compassion Fatigue Using Mindfulness Techniques, Christie Baker, Summer Cross

Student Scholarship & Creative Works

Demands placed on health care professionals have steadily increased and as a result, compassion fatigue has become an issue by adversely affecting the well-being of nurses and health care organizations. Compassion fatigue is a widely accepted phenomenon in nursing, creating an array of physical and emotional manifestations, impairing a health care provider’s ability to provide optimum quality care. The goal of this quality improvement project aimed to educate and provide emergency room nurses with a resource for self-care enhancement to subsequently decrease their risk of developing compassion fatigue. Nurses of a small, rural emergency department located in the southeastern region …

Adverse Childhood Experiences And The Impact Of Resiliency On Child Behavior: A Quality Improvement Project, Macy Kraft

Graduate Theses, Dissertations, and Capstones

Background: Adverse Childhood Experiences can have a significant impact on a person’s future health and wellness. Therefore, it is necessary for healthcare professionals to increase their understanding of possible mediating factors to lessen the impact of these experiences should they occur.

Purpose: The purpose of this project was to evaluate the effectiveness of an evidence-based quality improvement initiative designed to enhance the formal behavioral assessments of pre-school children following the participation of their caregivers in an ACEs and resiliency educational intervention.

Methods: Implementation of a two-armed intervention; a brief educational session aimed at providing an introduction to ACEs and a …

An Exploration Of The Experiences Of Perinatal Depression And Anxiety Among Pregnant And Parenting Adolescents In The Tampa Bay Area Of Florida, Olajumoke Adetoun Ojeleye

USF Tampa Graduate Theses and Dissertations

Perinatal depression (PND) and perinatal anxiety (PNA) are increasing among pregnant and parenting adolescents (PPAs), with PNA often underrecognized. This leads to significant socioeconomic costs and adverse maternal consequences if untreated. Hence, this dissertation explores the experiences of PND and PNA among PPAs, focusing on their knowledge gaps, perception, mental health needs, care preferences, and access to PMH care. The research employs a qualitative design (free-listing and in-depth interviews) to gather participant insights. Key findings reveal that many PPAs possess limited knowledge about PNA when compared to PND. Lack of support from partners, family, and peers emerged as the topmost …

Assessing Healthcare Insurance Policies In Mississippi: An Evaluation Of Public And Private Options, Latarsha H. Michael, Brieah D. Hudson

The Journal of the Research Association of Minority Professors

Medicaid is the main payer for maternity care in the U.S., covering nearly half of all births. Federal law provides postpartum coverage for 60 days, but gaps exist, especially in non-expansion states. The American Rescue Plan Act of 2021 allows states to extend Medicaid postpartum coverage to 12 months. Mississippi, where Medicaid covers 65% of births, faces severe maternal and infant health challenges. Despite its surplus, extending postpartum care to 12 months could cost $7 million annually. This study examines private and public health insurance coverage for perinatal care in Mississippi. This involves analyzing how different insurance policies address the …

Management Of Aggressive And Disruptive Behavior In The Emergency Department Using De-Escalation Techniques And Simulation: A Quality Improvement Project To Improve The Knowledge And Confidence Of Emergency Department Nurses And Clinical Staff, Ernestine Darby-Littlejohn

Electronic Theses and Dissertations

Abstract

Approximately 40% of all healthcare workers have reported episodes of violence by patients over the last 2 years. This Veteran’s Health Agency reported 824 disruptive events reported in the last 5 years, of which 56 occurred in the emergency department. Research shows that interventions are not always timely, resulting in the clinical staff requesting the Veteran’s Health Agency Police to intervene when a veteran’s level of stress is escalating. The gap in practice is shown to be related to a lack of knowledge in the clinical staff in managing high stress levels exhibited by some veterans, limited knowledge of …

Mindfulness-Based Interventions And Stress, Jacqueline Parker

Doctor of Nursing Practice Final Project Abstract

Purpose: Stress within the nursing profession is a substantial issue. Staff shortages, poor leadership, and even COVID-19 have contributed to an increase in nursing stress. Stress can negatively impact a nurse’s ability to perform at an optimal level while at work. The purpose of this project is to reduce perceived stress by implementing mindfulness-based interventions (MBI).

Background: The project was implemented in a twenty-three-bed unit that cares for the post operative pediatric population in Houston, Texas.

Methodology: A series of in-person and virtual educational lessons (eight total) on MBIs (with flyers) were implemented throughout this project. The Perceived Stress Scale …

Adverse Childhood Experiences: Healing Through Storytelling And Mindful Narrative Therapy, Julie Kemp

Mindfulness Studies Theses

This study presents research about the nature and prevalence of adverse childhood experiences (ACEs), the mental and physical impacts to individuals exposed to ACEs, and incorporating mindfulness practices into therapeutic approaches to treating them, particularly Mindfulness-Based Narrative Therapy (MBNT). It is important because ACEs have become a global crisis, with the potential for interfering with psychological and physical development, early mortality, and other harmful life outcomes. This thesis provides critical information for mindfulness teachers and practitioners, therapists, educators, regulators, parents, and individuals subjected to ACEs.

The methodology includes extensive literature searches for narrative therapy and mindfulness-based interventions (MBIs) in peer-reviewed …

How To Help New Nurses Deal With Anxiety And Stress, Jared Modzelewski Bsn, Rn

Posters

Background

New graduate nurses need to reduce their stress and anxiety to improve patient outcomes. Every nurse has some anxiety and stress, but new graduate nurses have been talking about it more. This change is necessary because improvement in mental health for nurses can improve their wellbeing and the overall quality of care they provide their patients.

Psychological Impact Of Ulcerative Colitis On Pregnancy And Postpartum Period, Stephanie C. Carver

Nursing | Senior Theses

Background

Ulcerative colitis (UC) poses significant challenges during pregnancy, affecting both physical and mental health. While the physiological effects of UC during pregnancy are well documented, less is known about its impact on maternal mental health. This study aims to investigate the psychological effects of UC on pregnant women, focusing on stress levels, postpartum depression (PPD) incidence, and the role of multidisciplinary care in improving mental health outcomes.

Objective

The primary objective of this research proposal is to evaluate the psychological impact of UC during pregnancy and determine whether disease activity increases the risk of PPD and stress. A secondary …

Improving Maternal Mental Health: The Role Of Specialized Support For Queer Women With Postpartum Depression, Dan-Tam Pham

Nursing | Senior Theses

Queer women face disproportionately high rates of postpartum depression compared to heterosexual and cisgender individuals. Studies showed that queer women face heightened mental health challenges, including higher rates of depression and anxiety due to factors like discrimination, limited support systems, and negative healthcare experiences. There is a need for culturally competent, LGBTQ+-affirming interventions to improve maternal mental health outcomes; despite the health disparities faced by this population, research on specialized postpartum interventions is limited, revealing gaps in effective mental health care for queer mothers. The key search terms for the articles used in the study included: postpartum depression, queer women, …

Mental Health Stigma As A Barrier To Care, Whitney Grant

Regis University Student Publications (comprehensive collection)

Abstract

Mental health stigma is a major barrier to care. The mental health stigma as a problem is relevant due to its influence on increasing the burden of mental health issues due to a lack of help-seeking, contributing to increased healthcare costs, and increasing adverse health outcomes. Currently there is no action consistently taken to assess or address this stigma in the primary care setting. Healthcare professionals can help to reduce the perceptions of stigma and lessen stigma as a barrier to care. A quality improvement project was implemented to evaluate if an education intervention by a primary care provider …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Recognizing Adult Male Mental Health Needs: An Intervention Looking At Education In Rural Communities, Eugene W. Winans Jr

Doctor of Nursing Practice Projects

This DNP Project examined the role of student nurses and their confidence levels when assisting adult male patients experiencing a mental health crisis. The majority of suicide acts are attributed to men. Thus, this subject requires specific insight and instructions when it comes to proper ways to assist these patients. Incorporating evidence from a pre-test and post-test survey, this project demonstrates that student nurses lack confidence in how to deal with men who are experiencing a mental health crisis. The analysis gained from this project demonstrates the important role nurses play in recognizing, speaking to, and assisting in the treatment …

Racial Health Disparities Among Pregnant Women Of Color In New York City: Biological And Systemic Impacts, Kaylin Peña

Pitzer Senior Theses

Racial Health Disparities Among Pregnant Women of Color in New York City: Biological and Systemic Impacts

Abstract

This thesis aims to explore how racial health disparities, underrepresentation in gynecology, and socioeconomic barriers contribute to adverse pregnancy outcomes among women of color in New York City. Through an interdisciplinary approach that combines resources from medical anthropology and human biology, this research will examine the biological implications of chronic stress, specifically HPA axis dysregulation, and its role in maternal health outcomes. With the idea of intersectionality, as conceptualized by Kimberlé Crenshaw, the study analyzes the various effects of systemic inequities and social …

Postpartum Depression In Adolescent Mothers: Evaluating The Effectiveness Of Screening Tools, Social And Cultural Interventions, Ysabella M. Co

Nursing | Senior Theses

Background: Pregnancies among adolescents is often an outcome of improper sex education and understanding. It is vital to provide mothers with the proper medical care and resources throughout their pregnancy and postpartum period to prevent any risks or harm from occurring. With the complexities and stressors of pregnancy at such a young age, it is important for healthcare to provide resources regarding postnatal depression diagnoses and interventions, especially to a population that is at risk for mental health issues. Objective: To provide adolescent mothers thorough medical care and lessen the risk of experiencing postpartum depression. By providing frequent …

Evaluating The Mental Health Of Newly Graduated Nurses In Transition From Undergraduate Training To Professional Practice, Victor Louis C. Alinas

Nursing | Senior Theses

Background: There is an increasing demand for nurses worldwide as healthcare systems slowly recover from the COVID-19 pandemic. Simultaneously, there is a high turnover of registered nurses and an even higher turnover in the demographic of newly graduated nurses. Newly graduated nurses (NGNs) are constantly faced with high levels of stress upon starting out in the professional environment and as a result of mental burnout and inadequate preparation, there is a notably high turnover of newly graduated nurses within their first year of employment. Purpose: This research aims to use existing information on the transition from undergraduate training to professional …

Preparing For Loss: The Impact Of Hospital-Based Parental Death On Sibling Relationships, Elyssa Thea Cajilig

Nursing | Senior Theses

The death of a parent is a profound and life-altering experience, especially for children and adolescents, who no longer have a parental figure to guide them through the struggles of processing grief and adjusting to life. Objective: The purpose of this study is to examine the impact of hospital-based parental death preparations on sibling relationships after the loss of a parent. Methods: This quasi-experimental, mixed method longitudinal study will explore the impact of structured hospital-based bereavement support on the quality of sibling relationships after parental loss. Quantitative surveys will assess relationship dynamics at three time points: immediately post-loss, 2 years …

Nurses’ Perception On The Gut-Brain Axis And Its Implications On Mental Health, Geethika Manoj, Celine Bautista

Nursing | Senior Theses

Background: Most medical interventions recommended for patients with anxiety and depression include pharmacological treatments and psychotherapy. Thus, undermining the existence of modifiable risk factors, such as diet. Despite being an area of growing research, the gut-brain axis is a very broad topic among the healthcare field. Purpose: The purpose of this study is to investigate registered nurses’ perceptions and understanding of the gut-brain axis and its implications for mental health management. Methods: This proposed exploratory descriptive study will conduct research among fifteen registered nurses, each with at least two years of experience in specialties such as gastroenterology, psychiatry, or hospital …

Reducing Levels Of Compassion Fatigue Among Generation Z Hospital Nurses, Kailani Yee

Nursing | Senior Theses

Background: Compassion fatigue is a critical issue and one of the many difficulties encompassed within the nursing profession. It affects a large number of registered nurses who work in hospital settings and who are constantly exposed to the suffering of others. With more young nurses entering the workforce, it's imperative that there is a better understanding of how to properly address this issue among the youngest generation of nurses: Generation Z, or those born between 1997-2012.

Objective: This research proposal aims to explore the most effective strategies to decrease levels of compassion fatigue in Generation Z nurses working in hospital …

The Impact Of Structured Weekend Group Therapy On Restraints, Seclusion And Length Of Stay On Inpatient Psychiatric Units, Victoria Grau

West Chester University Doctoral Projects

Group therapy is an essential part of inpatient psychiatric treatment, with documented positive effects including better medication compliance, lower readmission rate, and improved self- esteem. Patients who are admitted for an inpatient psychiatric stay have a small window of time in which behavioral health staff can work with them. Group therapy can help patients develop a plan for these issues and provide a foundation for successful discharge and symptom management. The project site is a mid-size teaching hospital in an urban community with higher rates of mental health diagnoses than the national average. Group therapy was conducted initially Monday – …