Nursing Commons^™

ผลของโปรแกรมการจัดการอาการร่วมกับการควบคุมความโกรธต่อพฤติกรรมก้าวร้าวของผู้ป่วยจิตเภท, พรประภา เหล็กกล้า

Chulalongkorn University Theses and Dissertations (Chula ETD)

การวิจัยครั้งนี้เป็นการวิจัยแบบกึ่งทดลองศึกษาแบบสองกลุ่มวัดผลก่อนและหลังการทดลอง มีวัตถุประสงค์เพื่อเปรียบเทียบพฤติกรรมก้าวร้าวของผู้ป่วยจิตเภทก่อนและหลังได้รับโปรแกรมการจัดการอาการร่วมกับการควบคุมความโกรธ และเปรียบเทียบพฤติกรรมก้าวร้าวระหว่างกลุ่มที่ได้รับโปรแกรมการจัดการอาการร่วมกับการควบคุมความโกรธ กับกลุ่มที่ได้รับการพยาบาลตามปกติ กลุ่มตัวอย่าง คือ ผู้ป่วยจิตเภทที่เข้ารับการรักษาในแผนกผู้ป่วยใน โรงพยาบาลสวนสราญรมย์ จำนวน 50 คน โดยใช้วิธีการเลือกกลุ่มตัวอย่างแบบเจาะจง เพื่อคัดกรองให้ได้กลุ่มเป้าหมายที่ต้องการศึกษาและควบคุมความแปรปรวน แล้วนำมาจับสลากหากลุ่มควบคุมและกลุ่มทดลอง หลังจากนั้นคัดเลือกผู้ป่วยที่มีคุณสมบัติตามเกณฑ์การคัดเข้า และจับคู่ที่มีลักษณะคล้ายคลึงกันในด้านเพศ และ คะแนนทางบวก แบ่งเป็นกลุ่มทดลอง 25 คน กลุ่มควบคุม 25 คน กลุ่มทดลองได้รับกิจกรรมการจัดการอาการร่วมกับการควบคุมความโกรธ กลุ่มควบคุมได้รับการพยาบาลตามปกติ เครื่องมือวิจัยประกอบด้วย โปรแกรมการจัดการอาการร่วมกับการควบคุมความโกรธ แบบบันทึกข้อมูลส่วนบุคคล แบบประเมินพฤติกรรมก้าวร้าว (KR-20 = .85) แบบวัดการแสดงความโกรธ (α = .81) และแบบประเมินความสามารถในการจัดการกับอาการทางบวก (α = .82) และแบบประเมินอาการทางบวก (α = .83) ซึ่งผ่านการตรวจสอบความตรงเชิงเนื้อหาโดยผู้ทรงคุณวุฒิจำนวน 5 ท่าน มีค่าความตรงเชิงเนื้อหาเท่ากับ 1 (CVI = 1.00) วิเคราะห์ข้อมูลโดยใช้ค่าเฉลี่ย ส่วนเบี่ยงเบนมาตรฐาน และสถิติค่าที ผลการวิจัยสรุปได้ ดังนี้ 1. ค่าเฉลี่ยคะแนนพฤติกรรมก้าวร้าวของผู้ป่วยจิตเภทของกลุ่มทดลองภายหลังได้รับการจัดการอาการร่วมกับการควบคุมความโกรธต่ำกว่าก่อนได้รับการจัดการอาการร่วมกับการควบคุมความโกรธ อย่างมีนัยสำคัญทางสถิติที่ระดับ .05 2. ค่าเฉลี่ยคะแนนพฤติกรรมก้าวร้าวของผู้ป่วยจิตเภทที่เข้าร่วมโปรแกรมการจัดการอาการร่วมกับการควบคุมความโกรธต่ำกว่าผู้ป่วยจิตเภทที่ได้รับการพยาบาลตามปกติ อย่างมีนัยสำคัญทางสถิติที่ระดับ .05

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

Sensory Modulation Training To Reduce Restrictive Interventions On An Acute Inpatient Psychiatric Unit At A Secure Psychiatric State Hospital: A Clinical Nurse Leader Quality Improvement Project, Fionna Norman

Master's Theses and Capstones

Abstract

Background: Symptoms of severe mental illnesses can result in Personal Safety Emergencies (PSE’s) in the acute in-patient psychiatric setting. As part of treatment of PSE’s, restrictive interventions such as seclusion are utilized in current practice to maintain the safety of the patient, peers, staff, and the environment. Evidence-based research has shown restrictive interventions can cause physical and psychological harm to both patients and staff. Reducing restrictive interventions continues to be a priority to create the most therapeutic environment possible. Evidence-based research has shown that sensory modulation is a non-restrictive intervention that can reduce the use of restrictive interventions, decrease …

Identifying Contributing Factors For Legal Placement Status In Involuntary Commitment And Voluntary Commitment In Child And Adolescent Psychiatry, Brianna R. Perry

Honors Undergraduate Theses

Background: Psychiatric hospitalization of children and adolescents can be carried out either voluntarily or involuntarily. The aim of this form of inpatient hospitalization is to provide treatment for those who cannot manage the symptoms of their mental illnesses on their own. However, psychiatric hospitalizations of children and adolescents are costly and could lead to outcomes such as worsened mental state in former patients and distrust of the system in caregivers. It is crucial to have a solid understanding of specific components that lead to the hospitalization.

Purpose: To identify potential trends in patient admission data through the analysis …

Relationship Between Internet Social Media Addiction And Communication Patterns Among Adolescents, Mona Hassan Abdelaal

Nursing

Abstract: Background: Internet social media and availability of mobile devices have an impact on the way people communicate. Adolescents have a wide range of positive and negative impacts come from the use of social media. Aim: Assess the relationship between internet social media addiction and communication patterns among adolescents. Design: A descriptive correlational design was utilized. Setting: The study was carried out at Technical Nursing Institutes in Benha city which consists of 2 Institutes and contain total (320) students from Benha Technical Nursing Institute for girls with total (170) students and from Benha Technical Nursing Institute of Health Insurance for …

Pandemic Paradox: A Mixed Methods Study Unmasking The Impact Of Covid-19 On Australia's Nursing And Midwifery Workforce Job Satisfaction And Retention, Laura Lillian Hynes

Theses

Background: The COVID-19 pandemic has seen an outpouring of attention focusing on the global nursing and midwifery shortage and its damaging impact on healthcare systems worldwide. However, there is limited research, both globally and in Australia, on its impact on nurses’ and midwives’ job satisfaction and their associated intentions to stay or leave their job and/or profession, as a result. The lack of extensive research in this area highlights the importance of this Doctoral thesis. My research aimed to fill this gap by conducting a detailed study of the personal experiences of nurses and midwives who worked during the pandemic …

The Impact Of An Educational Training To Front-Line Nurses And Providers To Reduce Seclusion And Restraint: Assessing Knowledge, Practices, And Attitudes, Kevin Bryant

DNP Projects

Background: The use of seclusion and restraint is common in hospitals, particularly in adult psychiatric settings. Although it is typically agreed that such measures should be used as a last resort in patient care, the majority of nurses feel that seclusion and restraint are necessary interventions in managing adverse behaviors of mental illness. There is a lack of data examining front-line nurses’ and providers’ knowledge, practices, and attitudes toward the use of seclusion and restraint following the use of a targeted educational training.

Purpose: This project aimed to evaluate the impact of a web-based educational intervention on the knowledge, …

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. …

Improving Structural Empowerment Through The Co-Creation Of A Professional Governance Program Of Nurse Managers And Front-Line Nurses, Michelle Van Outer

DNP Projects

Abstract

Background: Professional governance is a model in healthcare systems where nurses are involved by participating in decisions that lead their practice. Participation in professional governance has been shown to improve nursing practice, employee satisfaction, nursing autonomy, and patient outcomes.

Purpose: The purpose of this study is to evaluate nurses’ perceptions of empowerment when front-line nurses are involved with their nurse managers in the design and structure of an inpatient state psychiatric hospital’s professional governance program.

Conceptual Framework: Kanter’s theory of empowerment will guide this project. As individuals feel more empowered, the success of the organization increases. Kanter suggests that …

The Effect Of An Employee Recognition Program For Clinical Registered Nurse Retention At Eastern State Hospital, Kristi Richmond

DNP Projects

Abstract

Background: Nurse executives want to build and retain teams capable of delivering high quality care. However, registered nurse (RN) turnover continues to jeopardize this goal. RN satisfaction has been associated with reduced turnover in the nursing field. Adequate staffing levels are linked to better patient outcomes, and employee recognition is a key factor in RN retention.

Purpose: The purpose of this study was to evaluate the effectiveness of utilizing an existing recognition tool for RNs at an inpatient state psychiatric hospital in the southeastern United States to determine level of job satisfaction, level of job loyalty, level of engagement, …

Implementation Of An Education Intervention Aimed At Intensive Care Unit Providers To Improve Knowledge Of And Screening For Cognitive Impairment Related To Post-Intensive Care Syndrome, Terry Harrod

DNP Projects

Abstract

Background: Post intensive care syndrome is a condition that can lead to a range of physical,

cognitive, and psychiatric issues and is frequently undiagnosed. Educating Nurse Practitioners,

Physician Assistants, and Physician Fellows who work in the ICU about post intensive care

syndrome and a cognitive screening tool like the MoCA can significantly enhance their

understanding and ability to diagnose a component of this syndrome.

Purpose: The purpose of this project was to evaluate the effect of an educational intervention

regarding post intensive care syndrome among ICU nurse practitioners, physician assistants, and

physician fellows treating patients within the ICU.

Methodology: …

The Effects Of Yoga On Anxiety And Sleep Quality Levels Among College Students, Larisa Lucas Mullins

DNP Projects

Background: College students have poor sleep quality due to a newfound sense of freedom, exposure to new influences, or poor sleep hygiene (Dinis & Barganca, 2018). Specifically, evidence supports a correlation between sleep latency in onset or lack of nighttime sleep and increased anxiety (Dinis & Barganca, 2018). Yoga has been shown to decrease anxiety, stress symptoms, and depression (Mullen et al., 2021). Teaching yoga techniques and encouraging routine yoga practice to college students may improve sleep quality and decrease anxiety.

Purpose: This project's purpose was to evaluate the effect of yoga education and videos on sleep quality and …

Electroconvulsive Therapy: Improving Psychiatric Rn Knowledge And Attitudes Using An Educational Module, Garrett Payne

DNP Projects

Abstract

Background: Electroconvulsive Therapy (ECT) is a robust, versatile treatment option for many psychiatric disorders and diseases, but systemic low levels of knowledge and negative attitudes exist towards the procedure among healthcare workers, specifically among psychiatric RNs. The negative attitudes surrounding ECT are most attributable to a misunderstanding of its uses, efficacy, procedures, and safety. Psychiatric RNs hold more negative beliefs and misconceptions about ECT than any other group of healthcare workers who directly care for patients receiving the treatment. Psychiatric RNs also demonstrate poor understanding of ECT treatment procedures and outcomes. Current evidence-based practice shows that providing psychiatric RNs …

ผลของโปรแกรมสุขภาพจิตศึกษาครอบครัวโดยบูรณาการกับแอปพลิเคชันไลน์ต่อพฤติกรรมการใช้ยาตามเกณฑ์การรักษาของผู้ป่วยจิตเภทในชุมชน, ศิริพร พึ่งตน

Chulalongkorn University Theses and Dissertations (Chula ETD)

การวิจัยกึ่งทดลองครั้งนี้ มีวัตถุประสงค์เพื่อศึกษาการเปรียบเทียบพฤติกรรมการใช้ยาตามเกณฑ์การรักษาของผู้ป่วยจิตเภทในชุมชนก่อนและหลังได้รับโปรแกรม และเพื่อเปรียบเทียบพฤติกรรมการใช้ยาตามเกณฑ์การรักษาของผู้ป่วยจิตเภทในชุมชนที่เข้าได้รับโปรแกรมกับกลุ่มที่ได้รับการพยาบาลตามปกติ กลุ่มตัวอย่าง คือ ผู้ป่วยจิตเภทและผู้ดูแลในชุมชนที่มารับบริการแผนกจิตเวชและยาเสพติดของโรงพยาบาลองครักษ์ จำนวน 40 คน จับคู่ให้มีลักษณะคล้ายคลึงกันด้วยอายุและเพศ สุ่มเข้ากลุ่มทดลองและกลุ่มควบคุม กลุ่มละ 20 ครอบครัว เครื่องมือวิจัย ประกอบด้วย 1) โปรแกรมสุขภาพจิตศึกษาครอบครัวโดยบูรณาการกับแอปพลิเคชันไลน์ 2) แบบวัดพฤติกรรมการใช้ยาตามเกณฑ์การรักษา 3) แบบวัดความรู้ความเข้าใจผู้ป่วยจิตเภทและผู้ดูแล เครื่องมือทุกชุดได้ผ่านการตรวจสอบความตรงเนื้อหาโดยผู้ทรงคุณวุฒิ 5 ท่าน วิเคราะห์ความเที่ยงของเครื่องมือโดยการหาค่าสัมประสิทธิ์แอลฟาครอนบาคได้ค่าความเที่ยงเท่ากับ 0.85, 0.78 และ 0.83 ตามลำดับ สถิติที่ใช้ในการวิเคราะห์ข้อมูล ได้แก่ ค่าเฉลี่ย ส่วนเบี่ยงแบบมาตรฐานและสถิติทดสอบที ผลการวิจัย พบว่า 1. พฤติกรรมการใช้ยาตามเกณฑ์การรักษาของผู้ป่วยจิตเภทในชุมชนที่ได้รับโปรแกรมสุขภาพจิตศึกษาครอบครัวโดยบูรณาการกับแอปพลิเคชันไลน์สูงกว่าก่อนได้รับโปรแกรม อย่างมีนัยสำคัญทางสถิตที่ระดับ .05 2 .พฤติกรรมการใช้ยาตามเกณฑ์การรักษาของผู้ป่วยจิตเภทในชุมชนที่ได้รับโปรแกรมสุขภาพจิตศึกษาครอบครัวโดยบูรณาการกับแอปพลิเคชันไลน์สูงกว่ากลุ่มที่ได้รับการพยาบาลตามปกติ อย่างมีนัยสำคัญทางสถิตที่ระดับ .05

Increasing Medication Adherence In Patients With Bipolar Disorder Using Mobile App Reminder, Emmaculate Ndifor

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Bipolar disorder (BD) is the fifth leading course of disability in the world, contributing to many co-morbid conditions and complications. Non-adherence to medication is prevalent in patients with BD. The aim of the project was to use an evidence-based technological intervention to enhance medication adherence in BD patients between 18- 65 years old at an outpatient behavioral health clinic.

Methods: Baseline assessment included a pre Morisky Medication Adherence (MMAS-4) questionnaire. The development of an intervention to improve medication adherence was based on Johnson’s (2002) Medication Adherence Model (MAM).

Interventions: Participants downloaded the Medisafe app, registered medications and set …

Implementation Of A Community Health Worker (Chw) Training Program To Improve Birth Outcomes, Emiko Maruri

Doctor of Nursing Practice (DNP) Projects

Background

Those who have been affected by any adverse childhood experience (ACE) have an increased likelihood of poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss.

Problem

Latina women have been identified by the Centers for Disease Control (CDC) as those most affected by ACEs. Further evidence supports those affected by 2 or more ACEs have poor birth outcomes.

Context

For this project, The Save the Children organization in partnership with the University of San Francisco Doctorate of Nursing Practice (USF DNP) students and Community Health Workers (CHWs) of the Central …

Implementation Of Fast-Track Triage Process To Improve Ambulance Patient Offloading Time (Apot) In A Psychiatric Emergency Services (Pes) Unit, Oke Augustine Umeugoji

Doctor of Nursing Practice (DNP) Projects

Abstract.

Background.

Ambulance delays in hospital EDs have recently been significant in the United States. This delay has been attributed to emergency department overcrowding, a record number of 911 calls, a shortage of ED staff (doctors and nurses), and poor resources available in the communities as alternatives to an ED visit. Local Emergency Medical Service Authorities (LEMSA) monitor and determine the community standards for measuring ambulance offload delays (AOD), usually in minutes.

Problem.

Lengthy ambulance patient offload times and their subsequent impact on EMS have been significant all around the state of California as well as nationwide. The ambulance delay …

Depression Screening Tool For Hysterectomy Patients, Dede C. Mihedji

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The prevalence of hysterectomies in the United States ranges from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing

depression preoperatively could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy.

Local Problem: Currently, there is no standard of practice to routinely screen for depression in preoperative patients scheduled for hysterectomy surgeries. However, as with any surgical intervention, there are risks of long-term complications. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). …

Enhancing Mental Health Assessments For Hysterectomy Patients: Implementing A Depression Screening Tool For Healthcare Clinicians, Dede Mihedji

Doctor of Nursing Practice (DNP) Projects

Background: Hysterectomies are prevalent in the United States ranging from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing preoperative depression could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy. Local Problem: Currently, there is no standard practice for preoperative depression screening in hysterectomy patients. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). Methods: To address the gap, clinicians attended a fifteen-minute Zoom course on the Patient Health Questionnaire 9 (PHQ-9) and its …

Reducing Care Companion Utilization In Medical-Surgical And Telemetry Units, Mary Jane B. Sagabaen

Master's Projects and Capstones

Abstract

Problem: The facility highly utilized sitters or care companions, negatively impacting the staffing plan, budget, and productivity. An average of 56 hours of care companions were used daily. This greatly exceeded the budget of 33 hours a day. Reassigning Patient Care Technicians (PCT) as care companions resulted in inadequate nurse support for patient care and increased cost for additional staffing needs. Despite this, the fall rate remained higher than the target.

Context: The patient population is mainly 65 years old and above, sometimes with confusion, dementia, delirium, and at high risk for falls and elopement. The culture included promptly …

Promoting Parent-Child Relationships Through Community-Based Family Wellness Programs To Improve Mental Health In Children, Maria Elena Falcon

Doctor of Nursing Practice (DNP) Projects

Objective: Adverse childhood experiences can affect a child mentally and lead to mental, health, and learning problems later in life. Establishing healthy parent-child relationships through family-oriented programs can promote mental well-being, improve behavior and learning in children and strengthen positive parent-child relationships.

Methods: A systematic electronic search using databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and PsycINFO, contextualized current research on the importance of parent-child relationships and their influence on mental health. The inclusion criteria for the review used were articles in the English language and relevant dates from 2014 to 2021. The key terms used …

Reconceptualizing Complex Post-Traumatic Stress Disorder: An Evolutionary Concept Analysis And Clinical Guide, Jessica Livingston

Doctoral Projects

Conflicting models of how trauma manifests into identifiable symptoms have been a source of controversy and perplexity among practicing mental health clinicians and diagnosticians. Complex post-traumatic stress disorder (CPTSD) is now an internationally recognized diagnosis since its inclusion in the 11^th version of the World Health Organization’s (WHO) International Classification of Diseases (ICD-11) in 2018. The American Psychological Association (APA) does not share this recognition of CPTSD as an individual diagnosis and instead opted to update the diagnostic criteria for PTSD to include DSO and a 4^th category of dissociative features rather than include CPTSD as a separate …

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …

Scaffolded Simulation In Psychiatric Mental Health Nursing Education, Lori Bobo, Stacy Mikel, Yolanda Chandler, Hungwei Tseng

Higher Learning Research Communications

Objectives: The purpose of this study was to investigate the impacts of using scaffolded clinical simulations on nursing students’ confidence in clinical reasoning, clinical judgment, and critical thinking skills. Next, we also attempted to gain insights into students’ perceptions of the benefits of scaffolded clinical simulations.

Method: We used a mixed-methods research design to investigate the impacts of using scaffolded clinical simulations on 133 second-semester baccalaureate nursing students’ confidence in clinical reasoning, clinical judgment, and critical thinking skills.

Results: Findings from this study indicate that students who perceived the benefits of scaffolded simulation activities (i.e., peer observations, debriefings, and self-reflections) …

The Effects Of Non-Pharmacological Interventions For Behavior And Psychological Symptoms Of Dementia: A Benchmark Study, Rachel R. Williams

MSN Capstone Projects

The management of behavioral and psychological symptoms of dementia (BPSD) in patients who reside in nursing homes can be challenging. These neuropsychiatric behaviors can include but are not limited to aggression, agitation, delirium, depression, and psychosis (Cloak & Al Khalili, 2022). Patients with BPSD often have difficulty expressing their needs due to the disease process, resulting in further complexity when managing behaviors. There are no psychotropic medications to treat BPSD specifically, but many are often prescribed to treat the symptoms or behaviors exhibited by patients. The use of psychotropics, especially long-term can cause a myriad of adverse effects and should …

Improving Post-Discharge Engagement Of Mental Health Patients In The Veterans Affairs South Texas Healthcare System, Nneoma Lewis

Doctor of Nursing Practice

Discharge from a hospital is a high-risk period for mental health patients, as 20% experience an adverse event within 30 days of discharge. Poor discharge engagement can lead to complications for recovery, which include an increased risk for readmissions, longer length of stay, increased risk for suicide, and death. Hospital stays cost the United States $377.5 billion dollars per year; there is pressure for hospitals, health plans, and providers to examine the admission and discharge processes to improve healthcare delivery, transition of care, and patient health outcomes. At a South Texas VA, 67.66% of mental health patients attended all their …

Implementation Of A Protocol To Improve The Intake Assessment And Treatment With Suboxone Among Patients’ Dependent On Opioids On Two Mental Health Crisis Units, Maeghan Dillon

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: In 2021,106,699 people died from a drug overdose and of these deaths, over 75% were related to illicit or prescription opioids (Centers for Disease Control, 2023). At two in-patient community crisis stabilization units for psychiatric care, many patients have a comorbid diagnosis of a substance use disorder and another mental illness. Treatment with Buprenorphine/naloxone (Suboxone) is associated with decreased opioid overdoses and related deaths; however, Suboxone inductions have not been a part of admission treatment.

Methods: This quality improvement (QI) project initiated a Suboxone protocol for eligible patients on two crisis in-patient stabilization units. The outcomes …

Anxiety Screening At A Psychiatric Inpatient Facility: A Quality Improvement Project, Irene Akwitti

Doctor of Nursing Practice

Background. Generalized anxiety disorder is characterized by persistent anxiety and uncontrollable worry occurring more days than not for a minimum of 6 months (Patriquin & Mathew, 2017). Presently, anxiety screening and evidence-based practice treatment for adults are suboptimal. It is impossible to overemphasize the importance of early diagnosis and prompt treatment of generalized anxiety disorder in patients. Purpose. The purpose of this quality improvement project was to implement the Generalized Anxiety Disorder-7 (GAD-7) screening tool, a validated, evidence-based instrument, in a psychiatric inpatient facility to improve early detection and treatment of anxiety disorders in patients. Methods. Staff members were educated …

Utilizing A Validated Screening Tool And Treatment Protocol For Managing Agitation And Violence In A Psychiatric Emergency Services Unit, Zarah Ashcroft

Doctor of Nursing Practice

Background and Significance. Agitation is a significant concern in psychiatric units. If not detected early, agitated individuals are at high risk for becoming aggressive and violent, potentially causing harm to themselves, hospital staff, and property. The Psychiatric Emergency Services unit receives agitated and violent patients with psychiatric illnesses and substance use disorders. Purpose/Goal/Objectives. This quality improvement project aimed to implement a treatment protocol using the Broset Violence Checklist (BVC) to promote the early identification and management of potential for patient violence and aggression. Methods/Key Activities. Staff education for the nurses and providers on assessing patients at risk for aggression and …

A Quality Improvement Project To Screen For Food Insecurity In Adults With Anxiety Or Depression, Kelsie Evelyn Kroll

Doctor of Nursing Practice

Background Food insecurity is the limited availability and inconsistent accessibility of healthy foods (Coleman-Jensen et al., 2022a). Food insecurity contributes to mental health problems. Individuals with food insecurity have greater odds of screening positive for depression and anxiety (Wolfson et al., 2021). The Hunger Vital Sign™ screening tool is a 2-questions evidence-based tool used to identify food insecurity (Hager et al., 2010). Purpose. Implement the Hunger Vital Sign™ tool at a non-profit behavior health clinic to identify food insecurity in adults who screened positive for anxiety or depression, offer resources for them to obtain nutritious food, and provide additional information …