Nursing Commons^™

Addressing Anxiety In Hospitalized Adults Using A Music Intervention, Raina M. Rochon

Student Scholarly Projects

Practice Problem: The practice problem is anxiety related to hospitalization among adults in an acute care setting. Increased anxiety can lead to other issues while hospitalized including disruptive behaviors.

PICOT: The PICOT question that guided this project was: In hospitalized medical-surgical adults (P), how does the implementation of a music intervention as an adjunct to standard distraction techniques (I) compared to standard care (C) affect symptoms of anxiety as observed by the rate of behavior de-escalation team calls (O) within eight weeks (T)?

Evidence: There were five systematic reviews, four systematic reviews with meta-analysis with high level of …

Implementation And Evaluation Of A Mental Health Referral Pathway For School Nurses., Jessica Rivera

Doctor of Nursing Practice Papers

Nearly one in six American children between the ages of six and 17 have a treatable mental disorder (American Academy of Family Physicians [AAFP], 2020). Still, less than half do not receive help from a mental health professional (Whitney & Peterson, 2019). School nurses have an opportunity to bridge the gap by improving youth access to mental health care. Purpose: The purpose of this quality improvement project was to implement and evaluate a mental health referral pathway for school nurses. The specific aims were to improve school nurses' preparedness to recognize and address mental health concerns and to increase the …

Addressing Stress In Graduate Nurse Practitioner Nursing Students, Shandria K. Sawyer

Electronic Theses and Dissertations

This project was developed to address the issue of high stress levels among graduate nursing students, which is a common phenomenon that increases the risks of mental health disorders, professional burnout, and poor-quality patient care among students and professional nurses after earning their degrees. This project sought to utilize a simple educational intervention delivered online to impart coping skills to graduate nursing students to assist them in reducing their stress levels. The intervention was a brief, single-session, self-guided educational module featuring informational and participative elements related to stress causes, the impacts of stress, and stress reduction techniques. In total, 11 …

The Effect Of Transfer Of Care Protocol On The Rehospitalization Rates In Psychiatric Patients, Fernando Guillen Msn, Cnp, Pmhnp-Bc

Student Scholarly Projects

Practice Problem: The problem involved the transition of psychiatric care from long psychiatric hospitalizations to community-based psychiatric treatment which has developed into shorter inpatient psychiatric hospitalizations, which in turn has developed into a significantly higher number of individuals being readmitted within one year of inpatient discharge.

PICOT: In adult patients undergoing inpatient acute psychiatric care (P), how does the use of a transfer of care protocol (I), compared to current transfer of care practice (C), affect the rate of readmission within 30 days for inpatient acute psychiatric care (O), in 10 weeks?

Evidence: The evidence from an extensive literature review …

Metabolic Monitoring For Veterans Newly Prescribed Antipsychotic Medications: Enhancing The Process With Nursing Interventions, Charles W. Langnehs Jr

Graduate Theses, Dissertations, and Capstones

People who have severe mental illness are known to experience comorbidities and have shorter lifespans than those in the general population. There are many confounding reasons for those in this population to experience comorbidities that shorten their lives. However, it is commonly recognized that metabolic changes caused by medications taken to treat severe mental illness play a major role in the development of comorbidities and early mortality in those who take them. Drug manufacturers and several major organizations recommend the close monitoring of the metabolic status of those prescribed drugs in the class of medications known as antipsychotics. However, literature …

Evaluating Sbirt In A Behavioral Health Urgent Care, Christina L. Williams

Dissertations

Background: Adolescent substance use (SU) is a major health concern. Most youth who engage in alcohol and other SU do not meet criteria for SU disorder (SUD). Nonetheless, evidence shows SU during adolescence impacts cognitive, social, and emotional development, increases risk of physical injury, and may progress to SUD in adulthood. Only half of clinicians properly screen adolescents for SU; those identified with SUD often receive no intervention. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based intervention to address this problem. The purpose of this project was to evaluate implementation of SBIRT using CRAFFT 2.1+N, a SU …

Education To Improve Long-Acting Injectable Antipsychotic Use, Travis Donald Wolfangel

Dissertations

Purpose: Long-acting injectable (LAI) antipsychotics are underutilized as an evidence-based treatment for schizophrenia and schizoaffective disorder. The purpose of this quality improvement project was to determine if a web-based LAI education module changed advance practice prescribers’ knowledge, attitudes, and practice behaviors regarding LAI antipsychotics one month after receiving LAI education at a community-based mental health organization.

Methods: This QI project was an observational pre- post-educational design. The 20-item Knowledge, Attitudes, and Practices (KAP) questionnaire was used to assess advanced practice providers’ knowledge retention, attitude changes, and practice modifications regarding LAI antipsychotics and prospective patient chart reviews were performed. …

An Evaluation Of Mindstrong™ Implementation With Graduate Nursing Students, Angela B. Sabblut

Dissertations

Problem: Nursing graduate students are at increased risk of greater stress, anxiety, and depression (Hoying, 2020; Melnyk et al., 2020). Cognitive Behavioral Therapy is the gold standard in the treatment of anxiety and depression (Hoying et al., 2020; Melnyk et al., 2015; Melnyk et al., 2020). MINDSTRONG™, a CBT-based training program, has been proven in many studies to be effective in helping individuals prevent or cope with these issues (The Ohio State University College of Nursing, 2020).

Methods: This Quality Improvement (QI) project was a descriptive-observational, pre-post design. Sample and setting were nursing graduate students from a Midwestern, middle-sized urban, …

Evaluating The Effectiveness Of Implementing Depression Screenings With Uninsured African American Adults, Pamela Talley

Dissertations

Problem: Uninsured African Americans are underdiagnosed and often untreated for depression. Individuals usually do not present to their primary care provider with a complaint of depressed mood, however, may report symptoms such as decreased energy, general body aches, digestive concerns, somatic complaints, or older adults' memory or cognitive problems. The purpose of this quality improvement pilot project was to examine the results of the implementation of a depression screening (PHQ-9) in a primary care setting for uninsured adults for detection, diagnosis, and treatment of depression in African American clients.

Results: The PHQ-9 screening questionnaire was given to 100% (N …

Readmit Clinical Risk Index: Identifying Risk Factors To Reduce 30-Day Psychiatric Readmissions, Victoria Faulkner

Dissertations

Abstract

Problem: There has been a growing concern in the past decades over the increase in community-based adults who require readmission to psychiatric care shortly after discharge. It is estimated that nearly half of discharged psychiatric patients will be readmitted within twelve months after discharge. This has been primarily attributed to the absence of screening tools and resources to assists behavioral healthcare providers in identifying socio-demographic factors contributing to readmissions. Screening tools like the READMIT Clinical Risk Index identify patients at risk for psychiatric readmission. This quality improvement project aims to identify socio-demographic factors that lead to 30-day readmission …

Evaluating Mindfulness On Loneliness In An Older Adult Population, Jessica Tieskoetter

Dissertations

Problem: Loneliness is a widespread public health concern and has negatively impacted mortality and health outcomes among older adults. This quality improvement project’s purpose was to evaluate mindfulness on loneliness and quality of life among adults aged 65 years and older, participating in a weekly befriending socialization program.

Methods: A descriptive cohort design was utilized to assess loneliness pre-and post-implementation of a mindfulness telephone line over three months. A convenience sample of 22 older adults enrolled in a befriending socialization program was used. The Iowa Model of Evidence-Based Practice framework was applied to guide the implementation of a practice change …

Community Health Worker Program - Substance Use Disorder In Pregnancy, Alicia Claire Kletter Dnp

Doctor of Nursing Practice (DNP) Projects

Background Substance use disorder (SUD) in pregnancy is a concern for mother, baby and community. Healthcare policies are increasingly calling for diversification of the workforce to meet healthcare needs. Community health workers (CHWs) are understood from the literature to be effective at bridging the gap between patient and healthcare provider, especially for vulnerable populations. Local Problem California’s Central Valley is majority Latinx and faces challenges from poverty, lack of medical resources, unemployment and SUD at rates which are higher than other communities. Combine SUD with pregnancy and the need for robust social connections, psychological support, and physical healthcare become even …

Treatment Pearls: Management Of Physical Healthcare Needs In Patients With Mental Illness, Leslie W. Miles, Brandon Thatcher, Michael C. Thomas, Blaine Winters

Faculty Publications

Clinicians caring for persons with mental illness should be aware of increased mortality, physical problems, and health disparities in this population. This article provides a brief overview of physical health problems in the context of mental illness as well as those related to psychotropic medications, and discusses strategies to manage treatment effectively.

Screening For Suicide Risk In The Outpatient Electroconvulsive Therapy Population, Cerah Nagata

Doctor of Nursing Practice Final Manuscripts

TITLE: Screening for suicide risk in the outpatient electroconvulsive therapy population

BACKGROUND: Reducing risk for suicide continues to be a national hospital patient safety goal. Suicide is the 10th leading cause of death in the United States and suicide rates have increased 33% in the last decade. It has been found that 83% of those who die by suicide received healthcare services in their last year of life, thus healthcare providers are uniquely suited to play a role in identifying suicidality. The Columbia-Suicide Severity Rating Scale (C-SSRS) is a validated tool developed by Columbia University, University of Pennsylvania, and the …

Improved Monitoring Of Depression And Suicidal Ideation In Low-Income Adolescents Through Evidenced Based Provider Education, Sunday Adeyeye

Doctor of Nursing Practice Final Manuscripts

Background: Adolescents from low-income status experience more prevalent thoughts of suicide than their financially secure peers. Nearly 15% considered taking their own life. Suicidal ideation among adolescents in California ranges from 4% to 67%. Depression and suicidal thoughts are underdiagnosed among adolescents, with higher disparities among minority and lower socioeconomic backgrounds.

Purpose: This project involved consistent screening of high-risk adolescents for potential depression and suicidal ideation using a patient health questionnaire recommended by the U.S. Preventive Services Task Force screening.

Process: This project involved adolescents 12–18 years old who had visited a federally qualified healthcare center in San Bernardino, California. …

Implementation Of The Edinburgh Postpartum Depression Screening Tool To Screen Mothers For Postpartum Depression In The Pediatric Setting, Vera Nikolaychuk

Doctor of Nursing Practice Final Manuscripts

Postpartum depression (PPD) is a mood disorder affecting mothers after childbirth. Research estimates that approximately 11%-18% of mothers in the United States and one in seven women in California suffer from perinatal mood and anxiety disorder (PMAD) such as postpartum depression. Untreated postpartum depression not only costs United States billions of dollars in healthcare expenditure annually, but also leads to health complications for both mother and baby. The American Academy of Pediatrics (AAP) recommends screening for PPD at 1-,2-,4-, and 6- month well visits. A screening and referral program were implemented in a pediatric setting to identify mothers at risk …

Increasing Mental Health Literacy In The Black Church, Jonathan Allotey

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project was to increase mental health literacy, assess stigmatizing attitudes, and increase help seeking behavior in leadership within an African American church.

Background: The Black church has historically been a central institution for community support and leadership within these churches are often ill equipped to address the mental health needs of congregants. African Americans underutilize mental health services and are reported to have more chronic mental illnesses. Lack of mental health literacy may result in difficulty recognizing the risk factors, signs, symptoms, and treatments related to specific mental illnesses.

Evidence Based Intervention and Methods: Participating …

A Qualitative Study On Nurse Facilitators Of Mind-Body Skills Groups, Paula D. Blake-Beckford

Mindfulness Studies Theses

The Center for Mind-Body Medicine (CMBM), founded by Dr. James Gordon, provides communities with evidence-based Mind-Body Skills Groups (MBSGs) that foster self-care, self-awareness, and self-expression. MBSGs range from 8 to 12-week series on various mind-body practices wherein group members meet, practice, and reflect on the impact of mind-body skills in their lives. Research has demonstrated that participants in MBSGs have positive outcomes. Healthcare professionals (HCPs), especially nurses, gain resiliency from MBSGs. As facilitators of MBSGs, nurses develop essential skills transferable to clinical and educational settings. MBSGs are therapeutic for adult participants with chronic stress. Prior to this thesis, only one …

Implementation Of A Primary Care Toolkit To Improve Dementia Diagnosis And Management In A Rural Setting, Meredith George-Wieland

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: There are six million people with dementia living in the United States and this number is expected to rise exponentially due to the aging population. In the United States, it is estimated that only two thirds of dementia cases are recorded during primary care visits and an estimated, one third of cases have been either missed or disregarded.

LOCAL PROBLEM: In a remote primary care clinic on Kodiak Island, off the southeastern coast of Alaska, there is a lack of dementia and related cognitive diagnoses in the primary care setting due to patients’ and families lack access to the …

Improve Primary Care Advanced Practice Nurse's Knowledge Of Depression By Educational Interventions And Treatment Recommendations, Dorothy Adams

Doctoral Projects

Poor medication adherence is one of the significant barriers to treatment for depression, often due to fears about side effects and insufficient knowledge among nurses. Educating primary care advanced practice nurses can help to improve understanding about symptoms of depression and the treatment recommendations. Education can help engage the primary care advanced practice nurses to improve patient understanding and thereby support better adherence measured as improved refill rates and follow-up reports. The refill rates will show if the patients under the primary care advanced practice nurses ‘care have been following the medications prescribed in the right frequency and dosage. The …

The Outcome Of A Multidimensional Intervention Strategy For The Management Of Generalized Anxiety Disorder In An Internal Medicine Setting, Nicholas Davidson

Evidence-Based Practice Project Reports

Anxiety disorders are very prevalent in the United States. The most common type, Generalized Anxiety Disorder (GAD), affects 6.8 million adults every year. GAD can cause significant deficits in a person’s ability to function, decrease their quality of life and increases a person’s risk of attempting suicide. The purpose of this evidence-based practice (EBP) project was to improve the outcomes of adults diagnosed with GAD in an internal medicine setting by implementing a protocol composed of a combination of interventions. A thorough literature search was conducted to find the best available evidence to support the project. A total of 11 …

Maternal Distress In The Neonatal Intensive Care Unit, Morgan A. Staver

Theses & Dissertations

Maternal distress in the NICU is a common and potentially harmful phenomenon for mothers with a sick infant. The overall purpose of this dissertation was to describe maternal distress and to examine maternal distress among mothers who have infants greater than or equal to 34 weeks of gestation at birth in the NICU. This was accomplished by first conducting a concept analysis of maternal distress in the NICU. Next, an integrative review of the literature was done to assess maternal distress and associated variables in response to infant hospitalization in the NICU. Finally, a mixed methods study was done to …

Implementation Of Community Health Workers To Improve Birth Outcomes, Emiko Maruri, Trinette Radasa, Jo Loomis

DNP Qualifying Manuscripts

Those who have ever been affected by an adverse childhood experience (ACE) have a greater likelihood of having poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss. Black and Latina women have been identified by the Center’s for Disease Control (CDC) as those most affected by ACEs. The direct relationship is that Black and Latinas therefore have poor birth outcomes. With the implementation of nurse trained Community Health Workers (CHWs), the impacts within the community includes decreasing health care costs, adopting healthier choices for mother and child, and providing support and …

Improving Depression Surveillance At The We Care Clinic, Kaitlin Springer, Emma Hanney

Doctor of Nursing Practice Projects

Depression is one of the most underdiagnosed and untreated disorders affecting more than 16 million people in the United States each year (Henry et al., 2020). Unmanaged depression can lead to emotional suffering, decreased productivity, reduced income, impaired relationships, and an increased risk for comorbidities (Sinisalchi et al., 2020). It can affect anyone, however, individuals who are non-white, female, undereducated, disabled, pregnant or postpartum, have low socioeconomic status, or lack social support are at an increased risk (United States Preventative Services Task Force, 2019). The Southern Illinois University Edwardsville We Care Clinic provides primary care to minority patient populations who …

Screening And Follow Up For Postpartum Depression: How To Improve Practice, Mallory Matusik

Evidence-Based Practice Project Reports

Postpartum depression (PPD) is one of the most common mental health conditions, affecting one in seven women during their reproductive years (American College of Obstetricians and Gynecologists [ACOG], 2018). The purpose of this evidence-based practice (EBP) project was to improve screening and management of PPD using the Edinburgh Postnatal Depression Scale (EPDS) screening tool and a protocol for appropriate treatment and follow up care for PPD. A protocol was created by the project leader with information on screening and diagnosis, follow up, and treatment for PPD. The protocol also included information on how to assess for suicidal and/or homicidal ideation …

An Exploration Of Covid-19 Impact On Healthcare Workers’ Mental Health In China, Jenny Yang

Nursing | Senior Theses

Background

In December 2019, the first confirmed human case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 occurred in Wuhan, China. By March 2020, the World Health Organization (WHO) had classified the COVID-19 outbreak as a pandemic due to the rapid spread of the virus to other countries. Many people have been affected by the COVID-19 pandemic in various aspects, especially front-line healthcare workers. Hospital working conditions are constantly changing to cope with the problems that arise from the pandemic. These problems can result in an unsafe patient-to-nurse ratio, understaffed healthcare workers in hospitals, equipment shortage, and increased …

Caregiver Satisfaction Of Telehealth Initiatives For Developmental Surveillance And Evaluation In Pediatric Autism Spectrum Disorder, Aashiyana Patel

The Eleanor Mann School of Nursing Undergraduate Honors Theses

PURPOSE: To examine parental satisfaction of a telehealth program aimed to improve the identification and diagnosis of pediatric ASD in Northwest Arkansas.

DESIGN/METHODS: caregivers referred to the Access for Autism clinic received a satisfaction survey regarding the telehealth practices the clinic employs. This 5-point Likert scale survey was designed to measure six different constructs associated with telehealth satisfaction: assurance, empathy, reliability, responsiveness, usability, and patient satisfaction

CONCLUSIONS: Telehealth is a suitable alternative to attending medical appointments. The key finding indicated that 40% of caregivers believed the level of care received to be equal in telehealth and in-person appointments.

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell

Undergraduate Honors Theses

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression …

How Did Covid-19 Impact The Mental Health Of Nurses, Pamela Bedoya

Senior Honors Projects

No abstract provided.