Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

Mental Health Screening For The Military Spouse: Prevention In Practice, Lura Allison Mcgrath

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

In recent years, a focus on mental health has moved to the forefront of healthcare. This is especially true when caring for United States military service members. The military spouses of these service members also struggle and suffer from mental health disorders. However, the mental health needs of military spouses often receive insufficient attention. Research shows military spouses are at an increased risk of developing mental health disorders and/or suffering from mental illness. A large contributor is the impact of the military lifestyle and its challenges for these spouses. However, research also reveals there has been minimal effort put …

Quality Improvement Project: Enhancing Staff Delivery Of Non-Pharmacological Interventions In Serious Mental Illness Care, Kimberly Vann

Doctor of Nursing Practice Projects

Serious mental illness places a significant burden on global healthcare systems, increasing hospital utilization and critically impairing patients' functional status. Often crippling, these illnesses are mostly treated with medication therapy despite proven research to show effective outcomes with holistic and non-pharmacological therapies. Non-pharmacological interventions (NPIs) are often underutilized in outpatient mental health settings. The purpose of this quality improvement project was to determine whether structured training impacted staff confidence in delivering NPIs and impacted documentation frequency in the electronic health record (EHR). The project was guided by the Iowa Model of Evidence-Based Practice and implemented using the Plan-Do-Study-Act (PDSA) cycle, …

The Impact Of Social Interaction On Patient Well-Being With Transition Into Long-Term Care Settings: A Review Of Interventions For Improved Patient Outcomes, Helen Whitney Harmon

Epsilon Sigma at-Large Research Conference

Abstract

Purpose: When individual patients are transitioned from home or acute care settings to more long-term care environments such as skilled nursing units or assisted living facilities, the residents are at an increased risk of experiencing loneliness, which is linked to depression, anxiety, and increasing cognitive decline, and other detrimental outcomes.

Aims: Combinations of peer-reviewed qualitative and quantitative research studies were analyzed to determine what factors contributed to changes in patient well-being, mental health and overall quality of life during these transitions.

Methods: One article focusing on preventable healthcare transitions in patient population was able to link higher medical acuity …

Can The Implementation Of The Pause Decrease Death Anxiety And Poor Mental Health In Practicing Nurses?, Lilli Meyer

Undergraduate Theses

Practicing nurses are frequently exposed to patient death, placing them at increased risk for death anxiety and compromised mental health. Despite this, there remains a lack of structured, in-the-moment interventions to support emotional processing within clinical settings. This study evaluates whether the implementation of “The Pause,” a brief moment of silence following a patient’s death, may reduce death anxiety and improve mental health outcomes among practicing nurses. A quantitative survey consisting of eight questions was distributed to nurses in the Louisville, Kentucky area over a three-month period, yielding 26 responses. Findings indicated that 80.8% of participants reported no improvement or …

Quality Improvement Project: Educating Nursing Faculty On Animal-Assisted Therapy: Enhancing Knowledge And Confidence To Improve Program Outcomes, Sarah J. Whitwell

Doctor of Nursing Practice Projects

The purpose of this quality improvement project was to evaluate whether an educational intervention on animal-assisted therapy (AAT) improved nursing faculty perceived knowledge and confidence in using AAT to improve program outcomes. The problem addressed was the limited knowledge and confidence among nursing faculty regarding the use of non-traditional, evidence-based strategies to support student mental health. This project was guided by the Stetler Model of Evidence-Based Practice and Lewin’s Change Theory and used a quasi-experimental, one-group pre–post design. The project was conducted with nursing faculty teaching in a baccalaureate program at a four-year public university in Oklahoma. A 10-item Likert-scale …

Implementing And Evaluating A Mental Health Education And Mindfulness Program For Police Officers, Patricia Lynn Young

Doctor of Nursing Practice

Background: Police officers are routinely exposed to occupational stress and trauma, contributing to an increased risk of anxiety, depression, substance misuse, and post-traumatic stress disorder (PTSD). Targeted mental health interventions are needed to proactively address their mental health. Purpose: This Doctor of Nursing Practice (DNP) project implemented and evaluated a mental health education and mindfulness program designed to reduce operational stress and increase knowledge and use of departmental mental health resources and mindfulness techniques among police officers. Methods: A pre–post intervention design was used over a 10-week period. Participants (n = 14) completed the Operational Police Stress Questionnaire (PSQ-Op) and …

M-O-M-S On The Bayou: Implementation Of An Intervention To Improve Mental Health After Disaster, E. W. Harville, Gloria Giarratano, M. Patterson, M. Schultheis, K. S. Dorans, S. Turner, S. Harris, S. Longo, K. Weis

School of Nursing Faculty Publications

Pregnant women are a vulnerable population after disaster. Their health may be improved through community-based support programs in addition to their standard prenatal care. We conducted a prenatal peer support program, Mentors Offering Maternal Support (M-O-M-S), focused on improving mental health in hurricane-affected areas in southern Louisiana. M-O-M-S consists of six biweekly sessions covering pregnancy acceptance, maternal role identification, family and partner relationships, preparation for labor/fears around labor, well-being/safety of self and baby, and post-delivery health and maternal-infant bonding. The program is led by a “mentor”, an experienced mother but not necessarily a clinician or social worker, who guides the …

The Impact Of Patient-Centered Care On Women With Infertility And Pregnancy Loss: An Integrative Review, Kaidynce R. Sweazy

All Electronic Theses and Dissertations

Introduction: Infertility affects roughly 17.5% of adults worldwide, while pregnancy loss occurs in up to 30% of pregnancies. These reproductive traumas increase the risk of developing a mental health disorder, such as anxiety, depression, or post-traumatic stress disorder (PTSD). The purpose of this review is to identify the influence of patient-centered care on psychological outcomes and experiences of care in women with infertility and pregnancy loss.
Methods: A literature search of the PubMed and Cinahl databases was conducted for original studies published from January 2016 to January 2026 that address the psychological outcomes and/or experiences of women who experienced infertility …

The Impact Of Night Shift On New Nurses: Effects On Mental Health And Work-Life Balance, Avery Windham, Abby Maruskin, Elizabeth Yoder

Williams Honors College, Honors Research Projects

This research examines the impact of night shift schedules on new nurses' mental health and work-life balance as they transition into professional practice. The transition from nursing school to the workforce presents challenges that are further compounded by shift work, which can disrupt circadian rhythms and contribute to stress, fatigue, and reduced job satisfaction. The purpose of this research is to evaluate how starting on night shift versus day shift influences nurses’ self-evaluation of work-life balance within their first year of practice. This systematic review synthesizes findings from peer-reviewed sources to assess the physical, emotional, and professional consequences of night …

A Guideline To Address Barriers To Mental Health Treatment Experienced By Law Enforcement Officers, Jacqueline Estrella

Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Law enforcement officers are exposed to repeated trauma on the job that may negatively affect their mental health. Officers may avoid seeking mental health treatment due to police culture, stigma, and other barriers which may increase risks for suicide, absenteeism, and maladaptive coping.

Objectives: Develop an evidenced-based guideline to address barriers law enforcement officers face in seeking mental health treatment.

Methods: The National Quality Measures Clearinghouse (NQMC) Domain Framework was used to guide a literature review to identify best practices suitable for a guideline. Articles were graded for strength based on the John Hopkins Nursing Evidence Based Practice (JHNEBP) …

A Case For Qualitatively Driven Mixed Methods In Nursing Research: A Methodological Discussion, Jennifer Hamilton, Cooper, Irene Ngune, Amanda Cole, Richard Bostwick, Debbie Louise Massey

Research outputs 2022 to 2026

Mixed methodology continues to grow as a rigorous and respected research design. However, the value of qualitatively driven mixed methods research within nursing is underrepresented. Qualitatively driven mixed methods, where qualitative data dominate meaning-making, have the potential to capture critical experiential elements pertinent to nursing research while supporting empirical rigour. This methodology paper argues for the importance of qualitatively driven mixed methods approaches within nursing research to enable greater understanding of complex phenomenon. Through discussion and case example the role of qualitatively driven mixed methods, including within a sequential explanatory design, are presented. Nurses and midwives are well placed to …

Nurses' Experiences Of Pain Management For Patients With Diagnosed Mental Health Conditions: A Systematic Review, Aaron Lapuz Alejandro, Middlewick, Seng Giap Marcus Ang, Rosemary Saunders, Irene Ngune

Research outputs 2022 to 2026

Aim: To synthesise the available evidence related to nurses' pain assessment and management practices for patients with diagnosed mental health conditions. Design: Mixed-methods systematic review. Data Sources: Medline, CINAHL, PsycINFO, SPORTDiscus and Psychology and Behavioural Sciences Collection. Methods: Databases search was conducted in March 2024 and updated in June 2025. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Data synthesis followed the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. Results: Of the 1318 eligible studies identified, 12 met the inclusion criteria. The included studies were methodologically robust overall but frequently neglected nonresponse bias and were predominantly conducted …

Mental Health And Art Adherence In A Multisite International Study: The Mediating Roles Of Social Support And Substance Use In People With Hiv, Joseph Awad, Wenxiu Sun, Diane Santa Maria, Rebecca Schnall, Panta Apiruknapanond, Tongyao Wang, Claudia Patricia Valencia, Christine Horvat Davey, Solymar Solis Baez, Sheila Shaibu

School of Nursing & Midwifery, East Africa

ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from N = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental …

A Program Evaluation Of Universal Screening For Depression In The Primary Care Setting, Samantha W. Burns

Doctoral Projects

Depression is a chronic condition affecting millions of Americans annually and is often associated with poor clinical outcomes, multiple co-morbidities, a negative economic impact, and an increased mortality rate. Many primary care settings have implemented universal depression screening programs following the recommendations of governing healthcare entities such as the United States Preventive Services Task Force (USPSTF) and Center for Medicare and Medicaid Services (CMS). Due to positive benefit, universal depression screenings have now been included as a quality measure in the Merit-based Incentive Payment System (MIPS) to increase organizational reimbursement. The Patient Health Questionnaire-9 (PHQ-9) is a widely used screening …

Quality Improvement Project: Nursing Faculty Mental Health Literacy Assessment And Evaluation, Elesha Roberts

Doctor of Nursing Practice Projects

Mental illness is a major healthcare concern affecting young adults enrolled in college. College students enrolled in nursing programs in particular face intense academic pressure due to the demands and rigor of the program. Students commonly report symptoms associated with depression, anxiety, and suicide. Nursing faculty often do not feel comfortable approaching students about these concerns and other related mental health issues. Many faculty members lack the knowledge and skill to identify mental health issues and provide resources to support students in need. Faculty should be mental health literate and aware of campus resources. The purpose of this quality improvement …

Quality Improvement Project Enhancing Documentation Practices In Community Mental Health Clinics, Carol Parker

Doctor of Nursing Practice Projects

Accurate and timely documentation are essential for safe, high-quality care in community mental health settings. This quality improvement (QI) project addressed inconsistent documentation practices among licensed, unlicensed, and Qualified Mental Health Specialist (QMHS) staff at an outpatient clinic. The purpose of the QI project was to implement and assess a structured in-service training program using the Accountable Health Communities–Health-Related Social Needs (AHC-HRSN) screening and documentation tool to improve staff knowledge, enhance documentation accuracy, and facilitate care coordination. Guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change Management Model, a pre- and post-intervention design was used. Fifteen staff members …

Gender Differences In Psychological Strengths Among Rural Adolescents, Angela Preston, Jodi Bullard, Rachel Smith, Ashlyn Peppler

Nursing Faculty Publications and Presentations

Purpose: Rural adolescents often lack access to mental health care along with increased rates of depression and suicide completion. While psychological strengths have been associated with positive outcomes globally, little is known regarding the prevalence of these indicators (hope, self‐efficacy, resilience, optimism, and gratitude) among adolescents living in rural Texas. The purpose of this study was to describe how rural adolescents report their psychological strengths and examine the data for potential gender differences.

Design and Methods: A secondary analysis of cross‐sectional data was performed on the RStudio platform using tests of central tendency and inferential statistics. Results: There were 425 …

Longitudinal Associations Between Maternal And Child Screen Use At 1 Year Of Age And Child Behavior And Development At 3 Years Of Age, Stephanie Sim, Juliana Zabatiero, Natasha Bear, Amber Beynon, George Thomas, Ravisha Srinivasjois, Brad Jongeling, Desiree Silva, Leon Straker

Research outputs 2022 to 2026

Background: Young children are increasingly exposed to evolving screen technology. International guidelines recommend no screen use for children under the age of 2 years, due to the potential for detrimental effects on behaviour and development. However, evidence for these guidelines is limited by inadequate consideration of device-specific effects (TV and mobile phone/tablet computer), maternal screen use, confounders such as maternal mental health and importance of effect sizes. Our aim was to investigate longitudinal associations of device-specific maternal and child technology use and covariates (including maternal mental health) with behavioural and developmental outcomes, to guide adults on screen use behaviours by …

Barriers To Mental Health Access Among Immigrant Populations In The U.S., Cecilia Menzinger

Capstones

No abstract provided.

Building Adult-Gerontology Acute Care Nurse Practitioner Student Competencies For Telemental Health Treatment Through Simulation, Amy Dievendorf Dnp, Aprn, Fnp-Bc, Agacnp-Bc, Phyllis Raynor Phd, Aprn, Pmhnp-Bc, Beverly Baliko Phd, Rn, Pmhnp-Bc, Abbas Tavakoli Drph, Mph, Me

Publications

Depressive disorders are common mental health conditions that are often undiagnosed or undertreated. Adult-Gerontology Acute Care Nurse Practitioners (AGACNPs) are educated in the management of acute and critically ill patients but are often uncomfortable identifying and treating mental health conditions. Telehealth instruction is useful in mental healthcare and is required as part of the AGACNP’s efficient patient care competencies. This article reports findings from a mental health-focused telehealth instructional activity integrated into an existing AGACNP curriculum. This instructional activity was designed to introduce students to telehealth delivery and build AGACNP competencies using telehealth technology to assess patients with depressive mood …

Quality Improvement Project: Standardized Medication Reconciliation Process Training: A Path To Improve Staff Medication Confidence, Christologus Obi

Doctor of Nursing Practice Projects

Medication reconciliation represents a critical safety process in psychiatric healthcare, where medication discrepancies affect up to 67% of hospitalized patients, with 30-40% potentially causing significant harm. This quality improvement project implemented a standardized medication reconciliation training program at a Texas mental health facility to address knowledge and confidence gaps among clinical staff. Using Kotter's 8-Step Change Model and the Iowa Model of Evidence-Based Practice, this quasi-experimental pre-post intervention study delivered three 30-minute interactive sessions to 12 multidisciplinary healthcare professionals. The evidence-based intervention introduced a 3-phase reconciliation model focused on obtaining accurate medication histories, documentation, and discrepancy resolution. Data collection used …

Policy Project: Creating An Animal Assisted Therapy Policy For A College Of Nursing, Brooke Peyton

Doctor of Nursing Practice Projects

Nursing students experience high levels of academic stress, anxiety, and burnout, which can negatively impact learning, professional development, and overall health. Evidence indicates that Animal-Assisted Therapy (AAT) has the potential to impact stress levels, improve community connection, and enhance overall well-being among nursing students. Many academic institutions lack structured policies to guide AAT programs into educational settings. The purpose of this Doctor of Nursing Practice project was to develop a formal AAT policy for the College of Nursing with standardized procedures to implement an AAT program. Rogers’ Diffusion of Innovations theoretical framework was used to guide the development of the …

Empowering Mothers: A Digital Intervention For Perinatal Mental Wellness, Morgan Edmunds

Doctor of Nursing Practice Scholarly Projects

Aim: The aim of this project was to develop a smartphone application prototype for peripartum mental health. The goal of this application was to enhance access to education and quality mental health care.

Background: Currently, in the United States, peripartum mental health conditions are the leading cause of maternal morbidity and mortality (The Joint Commission, 2023). There is a gap in education, screening, and treatment for peripartum mental health due to distrust and a lack of resources, including a lack of mental health providers (Dossette et al., 2024; Feldman & Perret, 2023). Therefore, there is a significant number of women …

Social Determinants Of Health In Lesbian, Gay, Bisexual, Transgender, Queer, And Other Sexual And Gender Minority (Lgbtq+) Older Adults: Impact Of Socioeconomic Disadvantage On Inpatient Hospitalizations, Jennifer T. May Phd, Rn, Anp-Bc, Devon Noonan, Susan G. Silva

Publications

Introduction

Little is known about the impact of socioeconomic disadvantage on lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) older adults (≥50 years). The aim of this study is to determine whether the distribution of LGBTQ+ inpatient hospitalizations are related to structural socioeconomic factors.

Methods

A secondary analysis of retrospective electronic health record data for LGBTQ+ older adults hospitalized from 2018 to 2022 was conducted at one large health system. The average county area deprivation index where the patient resided was calculated.

Results

The analysis included 2270 LGBTQ+ older adult inpatient hospitalizations, with 1508 (66.4%) from …

Assessing The Psychological Wellbeing And Resilience Of Frontline Health Workers In Uganda: A Cross-Sectional Study, Ahmed Sarki, Joseph Atukwatse, Gideon Mbithi, Sabina Odero, Mary Namuguzi, Bernard Mutwiri, Lestine Bitakwitse, Peninah Wachira, Kevinson Mwangi, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Health workers in the frontline are the major drivers of health systems in low- and middle-income countries. However, these health workers face both chronic and acute shocks and stressors that expose them to mental health problems which are often overlooked. We examined the prevalence of mental health problems, correlates of psychological functioning, and resilience of frontline health workers in Uganda.

Methods: We conducted a cross-sectional study comprising 1800 frontline health workers across all regions of Uganda from August through October 2023. We used tools such as the PC-PTSD-5, PHQ9, PSS, GAD-7, Oldenburg Burnout Inventory, and CD-RISC-10 to assess PTSD, …

Social Determinants Of Health In Lesbian, Gay, Bisexual, Transgender, Queer, And Other Sexual And Gender Minority (Lgbtq+) Older Adults: Impact Of Socioeconomic Disadvantage On Inpatient Hospitalizations, Jennifer T. May Phd, Rn, Anp-Bc, Devon Noonan, Susan G. Silva

Publications

Introduction Little is known about the impact of socioeconomic disadvantage on lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) older adults (≥50 years). The aim of this study is to determine whether the distribution of LGBTQ+ inpatient hospitalizations are related to structural socioeconomic factors. Methods A secondary analysis of retrospective electronic health record data for LGBTQ+ older adults hospitalized from 2018 to 2022 was conducted at one large health system. The average county area deprivation index where the patient resided was calculated. Results The analysis included 2270 LGBTQ+ older adult inpatient hospitalizations, with 1508 (66.4%) from …

Increasing Patient Satisfaction And Engagement By Improving Patient Intake Process In An Outpatient Mental Health Clinic, Hotenesia Njoroge

Doctoral Dissertations and Projects

This scholarly project aimed to enhance patient satisfaction and engagement by improving the intake process in an outpatient mental health clinic. Inefficient intake procedures, characterized by long wait times, communication gaps, and misreferrals, contribute to patient disengagement and dissatisfaction. A quasi-experimental pretest-posttest design evaluated a patient-centered intervention involving communication training, streamlined workflows, and real-time updates. Data were collected from 52 participants using Patient-Reported Experience Measures (PREMs) and qualitative feedback. Quantitative results revealed high satisfaction with staff respect (M = 4.19), communication clarity (M = 4.06), and facility comfort (M = 4.13). Wait time satisfaction scored slightly lower (M = 3.96), …

Improving Collaboration With Hospital Security And Nursing Staff, When Treating Patients In Acute Crisis, By Implementing A Modified Sbar Card., Yuna Choi

Doctor of Nursing Practice Papers

Inpatient psychiatric units provide assistance to patients experiencing acute mental health crises such as psychosis or suicidal ideation. Patients experiencing acute mental health crises can sometimes become agitated or aggressive towards staff, themselves, or other patients, which can pose a significant risk to everyone’s safety. The purpose of the project is to improve staff satisfaction and collaboration by standardizing the interdisciplinary communication between hospital security and nursing staff. Over a period of two weeks, the facilitator educated security and unit staff on a SBAR card during shift huddle to implement on the unit in the event of an acute mental …

Screening For Bullying In A Middle School Setting, Paige Bernau

Dissertations

Problem: Bullied youth are two and a half times more likely to experience depression and three times more likely to experience anxiety and suicidal ideation than their peers (Li et al., 2024). Schools represent a key access point for mental health support and treatment for youth (Duong et al., 2020). Despite this, schools typically do not have formal bullying screening integrated into student support services.

Methods: This program evaluation used a descriptive, observational design to evaluate a bullying screening program in a suburban middle-school. This program used the California Bullying Victimization Scale (CBVS) to assess for bullying victimization (BV) followed …