Nursing Commons^™

Development Of A Depression Screening Protocol For At Risk Patients Based On The Adverse Childhood Experience Questionnaire, Brittany J. Taylor

Doctoral Projects

Background: Adverse childhood experiences (ACEs) are associated with increased risk for adult depression. Utilization of the Patient Health Questionnaire Nine (PHQ-9), in combination with Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSMV) criteria, aids in the diagnosis of comorbid depression and assessment of severity.

Objectives: To standardize the process of screening new adult patients at a specialty care clinic for ACEs. Then, implement a depression screening protocol based on ACE criteria to identify adult patients with comorbid depression.

Methods: Demographic, ACE score, PHQ-9 score, and protocol implementation data collected and analyzed by the Doctor of Nursing Practice (DNP) …

Improving Depression Screening And Follow-Up In Primary Care Through Implementation Of An Evidence-Based Protocol, Cheryl Fowler

Doctoral Projects

Depression is a leading cause of disability in adults and is a major contributor to burden of disease (World Health Organization [WHO], 2018). The United States Preventative Services Task Force (USPSTF) provides evidence-based recommendations to promote disease prevention. Among these, is the recommendation that all adults, regardless of risk factors, should be screened for depression in the primary care setting with adequate systems in place to allow for appropriate diagnosis and management (USPSTF, 2016). The purpose of this Doctor of Nursing Practice (DNP) student project was to develop and implement an evidence-based protocol in the primary care setting with aims …

Improving A Midwestern Community Mental Health Organization's Smoking Treatment Services For Individuals With Serious Mental Illness, Leah J. Magnuson

Doctoral Projects

Tobacco smoking is the leading cause of preventable death in the United States. Billions of dollars are lost yearly in direct and indirect healthcare costs as well as lost work productivity due to smoking. While smoking rates have declined among those of the general population, they remain high among those with serious mental illness (SMI). Many of those with SMI desire to quit and are able to quit smoking when they are provided with appropriate interventions and resources. It is recommended for those with SMI to receive combined interventions in the form of pharmacotherapy and cognitive behavioral therapy to help …

Using The Rapid Assessment For Adolescent Preventive Services (Raaps) To Screen For Risk Taking Behaviors Of 13 To 18 Year-Olds In A Regional Family Practice Office, Megan E. Carpenter

Doctoral Projects

Risk-taking behaviors are a significant problem in the adolescent population and the three leading causes of mortality for adolescents are suicide, homicide, and unintentional injury (Heron, 2017). National organizations support screening for adolescent risk-taking behaviors and research demonstrates effectiveness of screening. This quality improvement (QI) project implemented the Rapid Assessment for Adolescent Preventive Services (RAAPS) screening tool at a regional family practice office as a vehicle to accomplish the objectives of increased identification of, and intervention for, risk-taking behaviors in adolescent patients. Included in the methods were baseline and implementation chart reviews that were used to assess the change in …

Adult Attention Deficit/Hyperactivity Disorder Quality Improvement Project, Danielle Miller

Doctoral Projects

Adults with Attention Deficit Hyperactivity Disorder (ADHD) vary widely in their symptom presentation and functional deficits, which can make management in the primary care setting challenging for providers (Morstedt, Corbisiero, Bitto, & Stieglitz, 2015). Measurement-based care is common in the management of medical disease, however is rarely used as standard practice in treatment of psychiatric disorders (Waldrop & McGuinness, 2017). As a result, treatment for psychiatric conditions, such as ADHD, may vary widely among clinicians and may result suboptimal treatment and patient outcomes (Waldrop & McGuinness, 2017). The proposed solution was to introduce the use of a standardized measurement tool …

Providing Preventive Health Education And Developing A Referral Policy And Toolkit To Increase Access To Primary Care For Individuals With Mental Illness, Phaedra Mclin, Stephanie Myers

Doctoral Projects

Treatment rates in primary care for the mental health population is traditionally low. Individuals with mental illnesses were at a higher risk for the development of chronic health problems (Ross et al., 2015). Substance Abuse and Mental Health Services Administration (SAMHSA) indicated that many people with serious mental illness die from preventable diseases. People with serious mental illness also have a higher mortality rate than those in the general population (SAMHSA, 2017b).

The purpose of this Doctor of Nursing Practice (DNP) project was to determine if educational training regarding specific chronic disease conditions influenced the attitude and knowledge of the …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …

Adolescent Substance Abuse Patients Within The Therapeutic Alliance: An Integrative Literature Review, Emily Decker

Grace Peterson Nursing Research Colloquium

Background: Adolescent patients with substance use disorders (SUD) struggle with seeking treatment, staying motivated during treatment, and are at a higher risk of relapse following treatment compared with other SUD patients. A positive therapeutic alliance between provider and patient has been shown to positively affect treatment outcomes. Therefore, describing interpersonal patient traits which influence this alliance is integral to keeping patients in treatment and preventing relapse post-treatment.

Objectives: The purpose of this integrative review was to identify interpersonal characteristics of adolescent patients with a substance use disorder which can significantly influence their therapeutic alliance with the provider, ultimately leading to …

Built Food Environment And Perinatal Depression: An Integrative Literature Review, Rachel N. Mileski

Grace Peterson Nursing Research Colloquium

Background: Built food environment contributes to food access and insecurity, which impactsmaternal health due to increased rates of perinatal depression.

Objectives: The purpose of this integrative literature review will be to (1) identify contributing factors of built food environments in communities that increase the rate of perinatal depression and (2) evaluate the current intervention programs and methods addressing these factors in order to provide recommendations for further research.

Method: An integrative literature review will be used, in accordance with the Ecological Model, to evaluate contributing factors and suggestions.

Results: Findings from this integrative literature review revealed a link that connects …

Evaluation Of Stress Resources In School Age Children By Fifth And Sixth Grade Teachers., Crystal Stephenson

Research Horizons Day Posters

No abstract provided.

An Exploration Of Why Healthcare Professionals Under-Report Observed Patient Aggression, Sydney Bonta

UNO Student Research and Creative Activity Fair

An Exploration of Why Healthcare Professionals Under-Report Observed Patient Aggression

Authors: Sydney Bonta & Lisa L. Scherer, Ph.D.

Advisor: Lisa L. Scherer, Ph.D.

According to the 2011 US Bureau of Justice Statistics report, medical professionals experienced the third highest proportion of workplace violence (WPV), with violence primarily emanating from patient. In a national survey of nurses employed in hospitals, 76% stated that they had encountered some sort of violence in their workplace (Speroni, Fitch, Dawson, Dugan, Atherton, & Leesburg, 2014). Similarly, patient aggression against physicians has long been a problem (Morrison, Lantos, Levinson, 1998). Despite this widespread exposure to WPV …

The Experience Of Being A Parent Of A Transgender Adolescent, Susan Martello-Gill

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Background: According to the Williams Institute at the UCLA School of Law, about 150,000 U.S. adolescents aged 13-17 identify as transgender (Singhal, 2018). Therefore, parents of these growing number of adolescents face the daily struggles of being a parent of a transgender adolescent.

Purpose of the Study: A scant amount of research exists on the multitude of issues that parents of transgender/ non-binary adolescents confront in seeking guidance and support with the challenges they face daily. There is little in the literature concerning the experience of being a parent of a transgender/non-binary teen. Hence, the purpose of this study …

Mental Health Concerns In African American Churches: Pastoral Preparedness In Counseling, Melody Samuel

Nursing Theses and Capstone Projects

African Americans rely heavily upon their pastors for more than spiritual guidance. Pastors are known as gatekeepers in the African American community serving as a resource to address a multitude of issues for their congregant from personal issues such as finances and marital issues, grief and bereavement, to physical and mental health issues. The aim of this study was to examine pastoral preparedness for counseling of mental health concerns in the African American church. To better understand the demand of mental health counseling for their congregants and assess the pastor’s perception of educational and training needs, 35 pastors and/or associate …

Understanding The Autism Spectrum Disorder Population: An Opportunity To Improve Patient Care, Jean A. Timmons

Nursing Theses and Capstone Projects

There is a documented need for caring education regarding patients with autism spectrum disorder (ASD) for nursing students and nursing staff. The autism spectrum population is increasing, one in 59 children in the United States as reported by the CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network (as cited in Baio et al., 2018). Nurses are expected to provide appropriate care, showing respect and understanding at all times to both the client and family. Through lack of knowledge and misunderstanding the ASD population has not been given this care. Based on Watson’s Theory of Caring, an educational ASD caring program …

An Assessment Of Attitudes And Perceptions Of College Students Toward A Suicide Program On A College Campus: A Descriptive Study, Rachel Tolliver

DNP Research Projects

OBJECTIVE: A baseline assessment examines the status of attitudes and perceptions about the suicide prevention program of a small, private, southeastern, Christian university. Gaps in the literature include the lack of baseline evaluations at universities before evidenced-based practice (EBP) interventions.

PARTICIPANTS: A purposive sample of sixty-nine sophomores classified as first-year students for the 2016-2017 school year. The study sample lived on campus both semesters of the 2016-2017 school year.

METHODS: Participants completed the retired Suicide Prevention Exposure, Awareness and Knowledge Survey (SPEAKS) – SV (Student Version) by the Substance Abuse & Mental Health Services Administration (SAMHSA) for the Garrett …

The Efficacy Of Meditation-Based Treatments In Relapse Prevention For Persons With Substance Use Disorders, Florence C. Bates

Honors Undergraduate Theses

Substance abuse is a global problem that has contributed to a variety of societal, financial, health, and familial strains. An increasing prevalence of illicit drug, prescription opioids, and alcohol abuse has created a need for re-evaluation of recovery and relapse treatments. This literature review examines the efficacy of meditation-based treatments for relapse prevention in persons recovering from Substance Use Disorders (SUDs). A comparative analysis of Mindfulness Based Relapse Programs (MBRP), an adapted MBRP-W program, and a Transcendental Meditation (TM) intervention was used to examine the success of meditation-based interventions. Research supports improvements associated with the meditation-based interventions including significant reductions …

Awareness Matters: Improving Healthcare Workers’ Self-Efficacy, Knowledge, Skills And Attitudes Related To Mental Illness And Suicide Prevention, Carlana J. Coogle

Doctor of Nursing Practice Projects

Problem Description

Healthcare workers’ (HCWs) negative stigmas, poor attitudes, and lack of knowledge impact the care delivered to patients with a mental illness or who may be suffering with suicidal thoughts.

Rationale

Raising HCWs’ awareness, knowledge and skills have been linked to improving the negative stigmas, biases, and attitudes that impede the care required to achieve optimal health outcomes.

Intervention

Participants attended a 90-minute Question, Persuade, Refer (QPR) gatekeeper training, each participant received six bi-weekly emails about mental health issues, suicide prevention, and community resources. A pre/post survey design using the Mental Illness Clinicians’ Attitude Scale (MICA-4) and the Mental …

Searching For A Sense Of Place: The Process Of How Adolescent Girls Overcome Suicidality, Tamara Keefner

Electronic Theses and Dissertations

Suicide and self-harming behaviors are significant public health problems among children and adolescents globally and in the United States. Despite significant advances in recent decades to understand, prevent, and treat childhood and adolescent self-harming and suicide, suicide rates remain high. Since the National Action Alliance for Suicide Prevention set a goal to reduce suicide deaths and attempts by 40% by 2020, there has been a paradigm shift in the study of suicide yielding significant advances in the understanding of suicide and other forms of self-inflicted injury. This dissertation highlights some of the new developments in the study of suicide. First, …

An Educational Intervention For Skin Cancer Prevention With Hospital Staff: A Pilot Project For System Change, Amy Fran Bruce

Graduate Theses, Dissertations, and Problem Reports (ETD)

PURPOSE: The purpose of this project was to design, implement, and evaluate an educational intervention provided to health care professionals using the Sun Smart U Curriculum created by the Skin Cancer Foundation (2017).

METHODS: Using a pretest-posttest design with a convenience sample (N=40), this intervention targeted the health professionals and staff from a residential/acute care facility caring for pre-adolescent, adolescent, and adult populations. Aims of this project included: (1) the staff’s baseline level of knowledge regarding sun protective behaviors using the Sun Smart U Curriculum, (2) the staff’s level of knowledge regarding sun protective behaviors post educational intervention …

Trauma-Informed Care: Needs Assessment In A Pediatric Intensive Care Unit, Christine Young

DNP Projects

It is estimated that over 60 percent of children and adolescents in the United States have experienced one or more traumatic event (Saunders & Adams, 2014) resulting in increased psychosocial needs. Trauma-Informed Care (TIC) involves recognizing and validating the effects of trauma and promotes for effective treatment. The purpose of this Doctor of Nursing Practice (DNP) project was to describe the frequency of neglect and trauma, including abuse and accidental events, among patients admitted to a pediatric intensive care unit and identify types of interventions and referrals documented by providers in the medical record. This project was based on a …

The Effect Of A Behavioral Health Specialist Program On Providers’ Perceptions Of Mental Illness, Self-Efficacy And Satisfaction In The Inpatient Medical Unit., Trinity D. Thomas

DNP Projects

PURPOSE: The purpose of this DNP project was to assess the effect of a Behavioral Health Specialist (BHS) program on providers’ perceptions of mental illness, self-efficacy and satisfaction in the inpatient medical unit.

METHODS: This DNP project used a mixed-methods approach to obtain data, which included a pretest-posttest design, and key informant interviews. The survey data was obtained from provider responses to an email that was forwarded from managers of four targeted medical-surgical floors. A cover letter was included in the email which further provided information about key informant interviews and the contact information for the principle investigator to arrange …

Improving Emergency Department Nurses' Self-Perceived Self-Efficacy In Early Recognition Of Patients In A Mental Health Crisis, Mary Kay Silverman

DNP Scholarly Projects

Abstract

The two largest counties within Southwest Florida (SWFL) are Lee and Collier where mental health evaluations for children under the state’s Baker Act have more than doubled between 2011 and 2017 (Gluck & Zeitlin, 2019, p. 4). Given the marked increase in mental health evaluations, early recognition, assessment with initiation of treatment by nurses in the pediatric emergency department (ED) who present with behavioral health complaints must be a priority for emergency department leaders. Purpose: This quality improvement (QI) project proposed to improve a nurses’ self-efficacy through expanding knowledge in the recognition and identification of the signs and symptoms …

Peer Support For Addiction In The Inpatient Setting, Rebecca Sweeney

DNP Scholarly Projects

Background: In 2006 the Institute of Medicine reported that combined mental illness and substance use disorder was the second leading cause of disability and death in women and the highest cause in men. More recent data obtained from the 2016 National Survey on Drug Use and Health (Ahrnsbratz et al 2016) indicates in 2016 only one in ten of the people who need treatment, receive it. At Cambridge Health Alliance’s Everett Hospital, the site of this pilot project, opioid overdose and acute alcohol intoxication comprise one in every ten visits in the Emergency Department. In January of 2018, CHA partnered …

Evaluating State Anxiety Levels In Nursing Students, Rachel Stevens, Rachel Nussbaum, Tyler Blake

Williams Honors College, Honors Research Projects

Anxiety, dependent upon the frequency and severity, can be a serious problem that reduces physical, cognitive, and clinical performance. Nursing students have been found to experience especially high levels of state and trait anxiety which, according to Dorothea Orem’s self-care deficit theory, causes a deficit in health promotion and the health of oneself. There is little evidence available about how progression through a baccalaureate nursing program in the United States impacts anxiety. This research investigates anxiety in baccalaureate nursing students and how progression through the program influences self-reported anxiety levels. A descriptive cross-sectional study was performed on a convenience sample …

Relationship Between Emotional Intelligence And Self- Efficacy Among Psychiatric Mental Health Nurses In Clinical Practice, Mona Hassan Abdelaal

Nursing

Abstract: Emotional intelligence affects working relationships. In adequate self-efficacy could lead to poor performance. The purpose of this study was to explore the relationship between emotional intelligence and self-efficacy among psychiatric-mental health nurses in clinical practice. Setting and sample type: This study was conducted at Benha Psychiatric-Mental Health Hospital. A convenient sample of 150 nurses working in different departments was chosen. Research design: A descriptive correlational research design was utilized in this study to be achieving the purpose of this study. Instruments: one Instrument consisted of three parts were used in data collection. Part one: Social characteristics of nurses. Part …

The Effect Of Long Acting Injectable Psychotropic Medication Provider Education On Advanced Practice Provider Knowledge, Andrew Makowski

DNP Projects

Schizophrenia is a debilitating disease that affects approximately 21 million people worldwide (APA, 2013). The gold standard of treatment of schizophrenia is antipsychotic medications. Unfortunately, approximately 50% of patients become non-compliant with their prescribed medications (Sadock, Sadock & Ruiz, 2015). The purpose of this DNP project was to determine the effect of implementing an education intervention regarding long acting injectable (LAI) antipsychotics on the knowledge of advanced practice providers working at a state psychiatric hospital. The advanced practice providers that participated in this DNP project completed a pre-education assessment, attended a brief educational session regarding LAI antipsychotics, and completed a …

Change In Falls And Sitter Cost Post Implementation Of Remote Centralized Video Monitoring In Hospitalized Adult Patients, April Nicole Dougherty

DNP Projects

PURPOSE: Falls are the leading cause of injury in hospitalized patients. Patient sitter programs are proven to be an effective way to reduce falls in hospitalized patients. Innovative technologies have been examined that provide a safe and cost-effective way to reduce sitter costs and prevent falls. An innovative technology option is a remote centralized video monitoring system containing one video monitoring technician watching and verbally redirecting multiple patients at one time using mobile cameras. The purpose of this project is to evaluate the implementation of a remote centralized video monitoring system for adult patients in the acute care hospital setting. …

Evaluation Of Adolescent Adherence Treatment Following An Emergency Department Visit, Marcus Seaton

DNP Projects

Mental Health disorders affect 1 of 5 youth in the United States and are chronic conditions that affect adolescents’ ability to function at home, school, work, and with interpersonal relationships. Follow up adherence is imperative to ensure treatment goals are met. The purpose of this Doctor of Nursing (DNP) project was to examine factors associated with adherence to outpatient mental health (MH) treatment following an emergency department (ED) visit among adolescents admitted to an ED of a large hospital in a multi-system healthcare organization located in a metropolitan area of the southeastern United States (U.S.). This DNP project aims were …

The Effects Of Compassion Fatigue On Burnout Among Inpatient Psychiatric And Intensive Care Unit Nurses, Amita Madan Neidlinger

DNP Projects

PURPOSE: This DNP project is relevant to nurses of the psychiatric and Intensive Care Unit (ICU) setting, as high stress environments may produce higher rates of compassion fatigue and burnout. Investigation of these areas may help illuminate unnecessary healthcare costs that are associated with these phenomena. This DNP project is important to the University of Kentucky’s healthcare system, its patients, and nurses. Increased absenteeism and increased medication errors are positively associated with the prevalence of compassion fatigue and burnout in nurses. Outcomes from this project will allow identification of unnecessary healthcare costs and encourage administrators to focus on reducing nurse …

Psychiatric Patients’ Perception Of Involvement In The Plan Of Care, Jaspal Kaur Gill

Dissertations

Background: There is an increased need to actively engage and involve patients in their care planning in healthcare facilities including psychiatric facilities (Wills, Riefer, Schauer, & del Vecchio, 2011). There has been a growing interest in patient-centered care and patients’ involvement in their plan of care as it leads to positive healthcare outcomes and increased patient satisfaction. However, there is a lack of research on how psychiatric patients perceive their involvement in the care planning while they are admitted to an inpatient psychiatric facility.

Aim: The aim of this qualitative phenomenological research study was to explore patients’ perception …