Psychiatric and Mental Health Nursing Commons^™

Improving Mental Health Support For Nursing Students Through Mental Health First Aid (Mhfa) Training Of Clinical Faculty, Amy Sands

Graduate Theses, Dissertations, and Capstones

This project aimed to implement a process improvement program at the Louisville campus of Galen College of Nursing to improve the mental health support for nursing students through the training of Clinical Instructors (CIs) in using adult Mental Health First Aid (MHFA) and the ALGEE actions described within that program.

Faith Community Nursing: Ministering To God's People In Ukraine Through Lamentation, Pam Dandre

International Journal of Faith Community Nursing

None

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

Effects Of A Compassion Fatigue Workshop On Psychiatric Mental Health Nurses, Johnnie Elizabeth Bower Bsn, Mary Johnson Dnp

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Compassion fatigue (CF) is a collection of symptoms associated with exposure to traumas experienced by other people. Nursing is one of the professions that experiences CF from recurrent exposure to patient and family distress and from potential acts of abuse at work. Nurses working in behavioral health are one of the highest at risk for CF. Of newly graduated behavioral health nurses, 17.5% leave the field after one year and 33.5% leave after two. Signs of CF include hopelessness, feelings of inadequacy, anxiety, depression, fatigue, and increased absenteeism. Training in self-care techniques and mindfulness builds nurse resilience and …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Scholarly Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Police Versus Non-Police Response To 988 Crisis Calls, Miriam A. Maloney-Mattheisen Bsn, Rn, Latrina N. Blakemore Msn, Fnp-Bc, Janelle M. Scullark Msn, Fnp-C, Jacqueline Sharp Dnp, Pmhnp-Bc, Sharon Little Dnp, Fnp-Bc, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

The 988 Suicide & Crisis Lifeline is a mental health-specific emergency line that became nationally available in July of 2022. This resource allows callers in crisis to connect with trained mental health professionals. Despite the initiation of this new dispatching service, there is still a significant shortage of trained mental health professionals to respond to these calls when they require emergency intervention. The present scoping review aims to determine whether non-police crisis responses correlate to improved outcomes when compared to police response as evidenced by reduced inpatient admissions, reduced arrests, and decreased presence of intrusive traumatic symptoms following intervention. …

Comparisons Of Using Alcohol, Coping Strategies, Anxiety, And Depression Between Usa And Taiwanese College Students, Pi-Ming Yeh Associate Professor, Cheng-Huei Chiao Professor, Jennchang Liou Professor

Epsilon Sigma at-Large Research Conference

Purpose: In this study, we compared United States (US) and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression.

Research Questions:

1. What were the differences in demographic characteristics, using alcohol, coping strategies, anxiety, and depression between US and Taiwanese college students?

2. What were the relationships between US and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression?

3. How much of US and Taiwanese college students’ anxiety and depression were predicted by their use of alcohol, coping strategies?

Methods: Four hundred and one US and 180 Taiwanese college students were recruited in this study. This was …

Development And Evaluation Of Trauma Informed Care Education For Licensed Nurses, Kristina O'Meara

Epsilon Sigma at-Large Research Conference

Trauma informed care nursing education is crucial. Trauma informed care is a method of providing health care which understands the likelihood of past and present traumatic events in patients and families. The experience of past or present trauma often led to chronic diseases, substance abuse disorder, fragmented health care, fears surrounding health care, chronic stress, and other negative health consequences. The purpose of this project is to increase licensed nurses’ awareness and ability to practice trauma informed care in clinical practice, as well as promote policy initiation within the health care facilities. Method planning integrated the Knowledge to Action Cycle. …

Comparisons Of Spiritual Well-Being, Psychological Well-Being, And Suicidal Ideation Between Usa And Taiwanese College Students, Pi-Ming Yeh Associate Professor, Cheng-Huei Chiao Professor, Jennchang Liou Professor

Epsilon Sigma at-Large Research Conference

Background: In Taiwan, there were 7,038 reports of attempted suicide among people aged 24 or younger in 2018. Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older.

Purpose: In this study, we compared United States (US) and Taiwanese college students’ spiritual well-being, psychological well-being, and suicidal ideation.

Methods: A total of 661 college students (481 from the US and 180 from Taiwan) were recruited to complete the survey study. This was a cross-sectional comparative research design. SPSS 28.0 was used to do the data analysis. Chi-square …

Implementation Of The Dynamic Appraisal Of Situational Aggression (Dasa) Tool On Inpatient Mental Health Unit, Maira Rodriguez

Student Scholarly Projects

Practice Problem: Inpatient mental health units are vulnerable to aggression and violence, which may lead to physical injuries. It is essential to implement proactive measures to prevent violence before it escalates.

PICOT: In an adult inpatient mental health unit (P), does the use of the Dynamic Appraisal of Situational Aggression (DASA) (I), compared to no screening for aggression (C) decrease restraints and seclusion, provide early detection and awareness of aggressive behaviors (O) within ten weeks.

Evidence: The DASA assessment tool has been tested in various settings, such as forensic and general adult mental health units. It has also been found …

The Impact Of Brief Electronic Guided Mindfulness Meditation On Anxiety Scores, Sierra King

DNP Scholarly Projects

In the United States, anxiety rates are on the rise for the general population (Goodwin et al., 2020a). Prolonged and frequent anxiety can become unprompted and problematic (American Psychiatric Association, 2021). Management of anxiety is crucial for overall wellbeing. Access to treatment and resources for anxiety may be limited in rural geographical locations (Morales et al., n.d.). This DNP project sought to determine whether a brief intervention of electronic guided mindfulness meditation (MM) by Insight Timer is effective in decreasing anxiety in a rural populous. Convenience sampling recruited a final total of 11 rural participants who participated in seven sessions …

Lived Experiences: Growing Up With A Seriously Mentally Ill Parent, Deborah Lindell, Elliane Irani

Faculty Scholarship

Introduction: Individuals with serious mental illness often have persistent and disruptive symptoms. These can profoundly affect their children's lives, exposing them to adverse social and psychological conditions. Such conditions can result in traumatic lived experiences during childhood, which can carry over into adulthood, influencing their self-perceptions and shaping their attitudes toward themselves and society. To gain insights into this phenomenon, this study explored the lived experiences of adults who grew up with a parent with serious mental illness and their perceptions of their lives in adulthood. Design: This study used an interpretive phenomenological design. Methods: Participants were invited to voluntarily …

Cultural Wounds Find Release: Art Therapy And First Generation Immigrants’ Mental Health, Crystal Soojung Yi, Dennis Chavez Calderon

Nursing | Senior Theses

Background: First-generation immigrants in the United States confront significant mental health challenges rooted in cultural identity conflict. Specifically, these challenges are linked to elevated rates of anxiety, depression, and post-traumatic stress disorder (PTSD), as indicated by Lindert et al. (2009). Art therapy holds promise as an intervention for treating mental health and identity conflicts in a variety of populations. Yet, little is known about how art therapy can improve the experience of first-generation immigrants experiencing cultural identity conflicts.

Objective: This study aims to assess the effectiveness of art therapy in improving the mental health and cultural identity conflicts of first-generation …

Evaluating The Effectiveness Of Culture Based Nurse-Led Education For Postpartum Depression In Primiparous Asian-American Women, Colleen Peralta

Nursing | Senior Theses

The postpartum period is a critical period in regards to maternal health, marked by various physical, emotional, and psychological changes. Among the vulnerabilities that arise, postpartum depression (PPD) poses significant risks. More specifically, Asian-American mothers with postpartum depression face unique challenges, including the stigma surrounding mental health. As mental health stigma remains prevalent within the Asian-American community, it can make it challenging for mothers to seek out mental health care for postpartum depression. To investigate, primary research articles about the perceptions and experiences of PPD and the interventions used to improve PPD outcomes were examined. A plan for a future …

The Education Prescription: Exploring The Potential Of Patient Education To Reduce Mental Health Issues In Hormonal Contraceptive Users, Maria Abraham

Nursing | Senior Theses

The many birth control options available impact a woman’s life, as hormonal contraceptives are commonly used but often misunderstood. These contraceptives, which contain progestin only, or estrogen and progestin combined, can come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches. They offer benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they may lead to adverse side effects which can include increased blood pressure, nausea, headaches, breakthrough bleeding, and a higher risk of blood clots, with research indicating a potential link between oral contraceptive use and a decline in the user’s …

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, …

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, …

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 …

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). …

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 …

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 …

A Picture Of Spirituality In Youth Living With Bipolar Disorder, Michelle S. Solomon

Electronic Thesis and Dissertation Repository

There is a paucity of literature concerning how youth living with bipolar disorder understand and experience spirituality. The management of bipolar disorder through psychosocial interventions such as spirituality is critical due to the chronic and complex nature of the illness and the fact that pharmacotherapy has not been found to fully restore mood and quality of life (Michalak et al., 2016; Miller et al., 2014; Sanchez-Moreno et al., 2009; Stroppa & Moreira-Almeida, 2013). Spirituality has been defined as being concerned with the ultimate questions in life; the meaning in life that a person gains in relation to something bigger than …

Implementation Of A Screening, Brief Intervention, And Referral To Treatment Protocol For Treatment Of Opioid Use Disorder In Post-Carceral Populations, Adaora Ede, Mary Johnson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Opioid use disorder (OUD) is a pressing public health issue in the US affecting marginalized populations the most. Within the correctional setting, 65% of inmates are affected with OUD, worsening health outcomes when untreated.

LOCAL PROBLEM: This evidence-based practice (EBP) project targeted justice-involved individuals with co-occurring OUD at a behavioral health clinic in Johnson City, Tennessee. This project aimed to improve outcomes related to recidivism and relapse through clinician education and the implementation of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol.

METHODS: Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was the guiding EBP model for the …

Mindfulness-Based Educational Module For Nurses Caring For Pediatric Mental Health Patients, Brianna Mai Desjardins, Katherine Marie Newnam

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Emergency pediatric nurses have the added stress of not only caring for medical patients but must also care for patients experiencing mental health issues. Many nurses feel unprepared to care for this specialized patient population. To bridge this gap, mindfulness-based interventions (MBIs) have been shown to provide nurses with the skills needed to care for mental health patients. This same concept can be applied to pediatric patients. Pediatric-focused mindfulness-based techniques can be used to help pediatric patients manage their symptoms.

LOCAL PROBLEM: The setting for this project was an urban pediatric emergency department in East Tennessee. At the state …

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 …

Identifying Risk And Improving Outcomes: Application Of The Gad-7 Screening Tool Used Among Patients With Chronic Pain In An Outpatient Setting, Connor J. Cochran

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: It is estimated that chronic pain affects one in every five adults and that one in every three adults will be diagnosed with an anxiety disorder within their lifetime, indicating an overlap in both chronic pain and anxiety. Early identification of anxiety in the outpatient setting has the potential to increase identification and referral rates to specialized care.

Local Problem: An outpatient primary care facility that treats patients with chronic pain located in Philadelphia, Pennsylvania was the project setting. Prior to implementation, there was no standard process for identifying anxiety in patients.

Methods: The Iowa model of Evidence-Based Practice …

The Effect Of Focused Client Education On Case Management & Readmission Rates In Homeless Individuals With Co-Occurring Disorders Admitted To A Jail Diversion Program, Pallavi Rao, Mary Johnson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Individuals with both mental illness(es) (MI) and substance use disorder (SUD) occurring simultaneously are known as having co-occurring disorders (COD). The rates of COD found among homeless individuals (H-COD) are higher than in the general population. The presence of both conditions prevents H-COD individuals from overcoming their hardships and places them at a higher risk of being involved in the criminal justice system.

Local Problem: Jail diversion programs (JDPs) admit a high rate of H-COD clients nationally and locally at the project site in Knoxville (JDP-K). The Office on Homelessness reported about 80% of those admitted to JDP-K are …