Psychiatric and Mental Health Nursing Commons^™

Post-Traumatic Stress Disorder Among Healthcare Professionals Working In Emergency Transport And Critical Care Settings, Keenan Mai

Nursing | Student Research Posters

No abstract provided.

Dnp Final Report: Conquering Rn Turnover: Implementing Flexible Scheduling To Improve Job Satisfaction, Camille Y. Parsee

DNP Final Reports

Nurse turnover is a complex problem for the nursing profession, especially in the behavioral health setting, where turnover rates are higher than the overall RN national average. The consequences of high nurse turnover include increased health costs, low-quality patient care, and staffing constraints. The association between nurse turnover and job satisfaction is profound because of their reciprocal relationship; therefore, implementing an intervention to help mitigate nurse dissatisfaction is essential to overcoming nurse turnover. Flexible scheduling is an intervention that gives nurses independence with their schedule which improves work-life balance and promotes nurse retention (Wright, 2017). The following PICOT question was …

Evaluating The Efficacy Of Medication-Assisted Treatment For First Episode Psychosis: A Scoping Review, Chanel Thomas Msn, Aprn, Fnp-Bc, Rn-Bc, Alexandra Wittenberg Bsn, Rn-Bc, Anttrenika Anderson Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that individuals with substance use disorder (SUD) receive medicated-assisted treatment (MAT), as a complete approach to substance use treatment (SAMHSA, 2019). However, treatment measures using combination treatment for SUD in individuals experiencing first episode psychosis (FEP) are seldom used. This scoping review assesses the efficacy of MAT in conjunction with antipsychotics compared to the use of antipsychotic monotherapy for FEP individuals on hospital readmission rates.

Methods

The authors conducted a literature review utilizing PubMed, EBSCO, Elsevier, Google Scholar, PsychINFO, and Medline from August 2020 to November 2022. Key phrases …

Decreasing Restraint Use By Utilization Of Agitation Assessment And Verbal De-Escalation Strategies In An Inpatient Non-Psychiatric Hospital, Kiera Paulo

DNP Qualifying Manuscripts

Background: This paper reviews the literature on ways to decrease the use of restraints in hospitals – specifically the use of agitation assessments and verbal de-escalation to be implemented in healthcare facilities to decrease the number of restraints being used to manage undesirable patient behavior and workplace violence incidents. Problem: Restraints have been shown to impede the nurse-patient relationship and cause emotional and physical trauma to staff and patients. They are no longer considered preferred management and in some circumstances can be considered abuse. Intervention: Agitation assessments and verbal de-escalation have been shown to produce less aggressive behavior and decrease …

Screenings To Decrease Pediatric Suicide, Jordan Bridges, Dana Schildmeyer, Amanda Austin, Laura Boesken

Posters-at-the-Capitol

This project aimed to examine the current practice related to mental health and depression screenings in pediatric patients. The benefits of implementing screening in schools in identifying depression and suicide risks sooner were also considered. This project focused on the correlation between earlier mental health screening and identification of these mental health disorders earlier in the life of pediatric patients and suicide rates. Current, published literature notes mental health screening in the pediatric population in schools is an effective method to facilitate monitoring and early intervention in detecting a mental illness. Schools implementing mental health screenings can result in increased …

Lived Experiences Of People With Substance Use Disorder As Healthcare Education To Develop Empathy For This Population, Whitney Bynum

Nursing | Student Research Posters

Stigmas that develop among healthcare workers regarding patients with substance use disorder include: "drug-seeking", "violent", and "unmotivated". These beliefs can decrease the quality of care provided and results in less people seeking out needed treatment. Healthy People's 2030 goals include reducing drug and alcohol addiction. In order to do this, healthcare workers need to show empathy and form trusting relationships with this patient population. Building a trusting relationship allows the patient to be more receptive to help and suggestions. Learning the life story of a patient can help healthcare workers develop empathy and reduce negative attitudes.

Effects Of Nurse-Patient Relationship On Mental Health Patients’ Medication Adherence/Healthcare Outcome, April Monica Magbual

Nursing | Senior Theses

Background and Significance: Medication adherence among mentally ill patients (MIP) is a significant issue which require extra support & guidance to encourage better recovery. Administering medication is a critical role of nurses that must be performed effectively and appropriately, especially for MIPs.

Literature Review and Gap in the Literature: There is insufficient research exploring NPR and medication adherence specifically for MIPs. Participants’ cultural variations, age range, specific interventions & economic factors influencing medication compliance are missing. The current study aims to explore strategies that nurses can implement during patient interaction in the hospital setting.

Study Design and Method: A qualitative …

Studying The Impact Of Hyperlipidemia Monitoring Tools On Referral Rates In Patients Taking Antipsychotics, Jasmyn S. Allen

Doctoral Projects

The purpose of this DNP project is to determine how well an evaluation tool may be used to track hyperlipidemia in patients using antipsychotic medicines who are between the ages of 20 and 50. Elevated lipid contents in the bloodstream, or hyperlipidemia, increase the danger of heart-related illnesses. Antipsychotic drugs, frequently administered for mental health disorders and dyslipidemia, have been connected. The goal is to ascertain whether utilizing an evaluation tool raises the three-month referral rates for hyperlipidemia to primary care (Dayabandara et al., 2017). The foundation of the research is found in several articles collected from different websites. According …

Effectiveness Of Staff Training On Trauma-Informed Care, Brandy Tramel Williams

Doctoral Projects

The connection between experiencing trauma and the development of substance use disorder is widely recognized. Although trauma is more prevalent among individuals with substance use disorders, healthcare professionals have limited access to training focused on trauma informed care. It is crucial for those working in addiction treatment to receive training and education on trauma informed care to understand the impact of trauma and its association with substance use disorders.

This DNP project's objective was to develop and evaluate an educational presentation for staff emphasizing the importance of trauma-informed care in the context of addiction. The effectiveness of this intervention was …

Improving Screen Time Review And Adherence To Age-Based Limits In A Fqhc, Erin K. Milner

DNP Projects

Background: Children in the US spend an average of 7.5 hours a day in front of a screen, well above the recommended 2 hours per day for entertainment. Screen time of greater than 3 hours per day is associated with higher body mass indices and insulin resistance that can lead to type 2 diabetes. Providers should review and reinforce age-appropriate screen time guidelines at well-child visits. Screen time education and behavior contracts can be used to facilitate age-appropriate screen time.

Project Goals:

1. To implement screen time education and behavior contracts in a pediatric population in a federally qualified health center …

The Effects Of Prolonged Exposure Therapy On The Symptoms Of Patients With Posttraumatic Stress Disorder, Hannah Belle Pontillas

Nursing | Senior Theses

The Diagnostic and Statistical Manual of Mental Disorders or DSM-5 defines posttraumatic stress disorder or PTSD as persistent psychophysiological reactions including intrusive memories of trauma, negative feelings towards such memories, and avoidance of related stimuli—all of which are a direct result of experiencing a traumatic event. The first line of treatment for this particular mental disorder is considered to be prolonged exposure therapy or PE therapy due to its high success rate in treating the symptoms of moderate to severe PTSD as it encourages patients to directly confront and overcome their trauma. However, PE therapy has garnered concern as it …

Emergency Department Safety With Psychiatric Unit, Mallorie Stiner, Sofia Splendore

Nursing | Student Research Posters

Background: Safety in the emergency department is of the highest priority with patient care for ED staff and psychiatric patients. Psychiatric patients are unpredictable and can have violent outbursts, especially in a mental health episode or under the influence of drugs and or alcohol. Research on psychiatric units in the emergency department has primarily focused on minimizing patient wait times, however, there is a lack of research on patient and staff safety. Objective: This thesis investigates the impact of incorporating a psychiatric unit staffed by mental health professionals and patient safety within the emergency department. Methods: This thesis will include …

Utilizing Outpatient Telehealth As A Treatment Approach For Patients With Substance Use Disorder: A Quality Improvement Project, Veronica Kwegyir-Afful

DNP Scholarly Projects

Background: The issue of substance use disorder (SUD) has demonstrated a growing prevalence both in the United States (U.S.) and globally. Effective treatment modalities have been devised for individuals afflicted by SUD, thereby enabling their post-treatment prognosis to be parallel to that of patients with other chronic diseases, such as diabetes. However, several factors or barriers impede individuals with SUD from assessing treatment. These barriers encompass financial constraints stemming from inadequate insurance coverage and high cost, the stigma surrounding SUD, which results in patient's hesitancy to seek treatment treat, adverse societal attitudes, collateral social percussions like work hour losses and …

Implementation Of A Death Anxiety Screening Protocol Specific To Patients With Advanced Cancer In An Outpatient Palliative Care Setting, Olivia M. Sasdi

DNP Projects

Abstract

Background: Recent studies have shown that upwards of 80% of patients with advanced cancer suffer from death anxiety resulting in increased physical and psychological suffering. Despite death anxiety’s ubiquitous nature and negative impact, the literature regarding this condition consistently indicates that it remains under-identified and undertreated in patients with advanced cancer. The “Death and Dying Distress Scale” (DADDS) is a clinically validated tool used to identify, measure, and guide effective treatment modalities for death anxiety specifically in patients with advanced cancer, but is scarcely used routinely in practice. Incorporating this screening tool to be used regularly could improve identification …

The Usability And Feasibility Of A Nursing Evidence-Based Comorbidity Educational Website For An Urban Mental Health Assertive Community Treatment (Act) Program, Andrea Brudigan, Laurie Sewell-Muller, Kokuvi Sena Tsogbevi

Doctor of Nursing Practice Projects: College of Nursing

Objective: Serious mental illness (SMI) causes an increased risk for comorbidities like heart disease, obesity, metabolic syndrome, and diabetes. Many times, these comorbidities are due to side effects of antipsychotics and poor self-management from low insight and other symptoms of mental illness. This project aims to enhance client care enrolled in an Assertive Community Treatment (ACT) program by providing evidence-based resources tailored to clients with SMI, providing ACT team members with support to promote healthy behaviors in clients.

Methods: A website was developed that provides printable, easy-to-read, evidence-based resources that address physical comorbidities. The ACT team integrated these resources into …

Postpartum Depression For Mothers With Early Fetal Death Or Stillbirths, Callie Goldman

Symposium of Student Scholars

Background: Many times, prevention of early fetus death and stillbirths is possible; however, some mortality events are spontaneous or unavoidable. While existing research reveals the likelihood of postpartum depression for mothers following birth, few studies address the potential for postpartum depression of mothers of stillbirth or demised fetuses. The purpose of this study is to determine how mothers can be better prepared for the hardship of losing a baby during childbirth, while going through common difficulties, such as postpartum depression, following birth. Methods: A mixed method approach will be conducted to gather qualitative (interview) and quantitative (Edinburgh Postnatal Depression Scale …

Effectiveness Of Non-Pharmacological Interventions When Treating Postpartum Depression In First-Time Mothers, Rudy Trujillo, Tamantha Minton-Damm, Ashley Muntean, Natalia Lack

Symposium of Student Scholars

Abstract

Non-pharmacological intervention alone or paired with pharmacological interventions is somewhat effective in treating and lowering rates of postpartum depression (PPD) in women. Undergraduate students reviewed studies of the use of pharmacological and non-pharmacological treatments for postpartum depression. To narrow down results, the students based the review on studies completed within the last 10 years, focusing specifically on primiparas (first births) women. Responses ranged from no notable efficacy in reducing PPD measured against the Edinburgh Scale to marginal improvements when non-pharmacological and pharmacological approaches were combined, and testing extended to other scales of motherhood and postpartum. The students discuss the …

Reducing Suicide Reattempts With A Telephone Follow Up Program, Bailey Breaux

MSN Capstone Projects

Suicide is one of the leading causes of death in the United States. Most people can say they know at least one person who has committed suicide or has considered suicide. The number of deaths continues to rise, and they aren’t stopping anytime soon. Many of these patients visit emergency rooms around the country seeking help for their depression and suicidal ideation. Some are brought into the emergency department following a suicide attempt and their visit only predicts another one happening in the near future. Some hospitals around the globe has tried to stop this recurrence of suicide reattempts by …

Implementing Evidence-Based Adult Psychiatric Inpatient Depression Assessment, Treatment, And Post-Hospitalization Referral, Lucy Flores

Doctor of Nursing Practice

Purpose: This project was designed to strengthen the quality of depression assessment with evidence-based depression assessment tools in inpatient psychiatric units.

Background: Missed diagnosis and treatment of depressive disorders contribute to the most severe outcome of depression: suicide. A crisis stabilization facility with inpatient psychiatric units had significant opportunities to improve clinical outcomes by screening for depression in adults and to monitor symptoms with evidence-based tools.

Methods: The 12-week quality improvement project included implementation of staff education sessions of evidence-based tools to screen, monitor, interpret scores, and detect risk modifiers. The design and build with Information …

Implementing The Depression Screening Tool Phq-9 In The Annual Wellness Exam Of Concierge Family Medicine, Eric Iglesias

Doctor of Nursing Practice

Abstract

Background: Depression has been one of the most common mental health disorders that our population fact but is underdiagnosed and undertreated. Primary care providers are often the first line of defense in detecting depression. Because of this, implementing a depression screening tool in a primary care setting will improve holistic management of care and improve quality of life.

Project Aim: The aim of this project was to increase the number of clients who are evaluated for depression by using the PHQ-9 screening tool during their annual wellness exam and initiate treatment according to the Veteran’s Affairs/Department of Defense Depression …

Substance Use Among Nurses As A Result Of Covid-19, And The Impact Of Rehabilitative Programs On Nurses, Gerome Macaspac

Nursing | Senior Theses

Background: The incidence of substance use among nurses has been a persistent issue for decades. The effects associated with substance misuse depend on what is used, the amount, how often, and how they are taken. Regardless of the substance used, any nurse who enters the workplace using substances puts the lives of others at risk. Due to the widespread effects of the COVID-19 pandemic, there is a risk that the number of nurses resorting to the use of substances may have increased. Therefore, an investigation into drug use among nurses during the pandemic is particularly important.

Objective: To explore the …

Reducing Physical Restraints And Emergency Psychiatric Medications On An Inpatient Psychiatric Unit With The Broset Violence Checklist, Victoria Hernandez

Doctor of Nursing Practice

Background: Physical restraint and psychiatric emergency medication use, especially psychotropic medications, is problematic, negatively impacting patient safety on psychiatric units (Ambwani et al., 2021; Iuppa et al., 2013; Rahman, 2021). The Bröset Violence Checklist (Woods & Almvik, 2002), a short-term violence-predicting tool, has been used in the inpatient setting to predict violent outbursts and determine when high-level violence interventions are needed.

Purpose: The purpose of this project was to recognize signs and symptoms of aggression and agitation early and intervene to reduce the use of physical restraints and emergency restraint medications on an inpatient psychiatric unit, thereby improving patient safety. …

Psychiatric Medications: Does Education Affect Medication Prescriptions?, Surina M. Narine, Mary D. Ramos, Sarah Chu

Symposium of Student Scholars

Background: There is a lack of research on racial challenges among underrepresented adolescents regarding prescription drug use for mental illnesses. Purpose: This study addressed the following question: In adolescent minorities, how does education about racial disparity and culture affect the stigma and number of prescriptions written for psychiatric medications? This evidence-based practice project aimed to identify if racial awareness directly impacts the amount of psychiatric medication prescribed for adolescent minorities. Methods: Literature reviews analyzed qualitative and quantitative data to provide correlating information on racial disparities and psychotropic medications. This study examined the following possible factors for decreased prescribed drugs within …

Depression Awareness Programs For Adolescents: A Scoping Review, Kincharska N. Freeman Msn, Aprn, Fnp-C, Cnor, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

The purpose of this DNP project is to determine if receiving school-based depression awareness education affects the depression scores of adolescents between 10 and 19 years of age.

Utilization Of A Multimodal De-Escalation Class To Improve Staff Confidence When Caring For Behaviorally Escalating Patients, Tara B. Neuner

Graduate Theses, Dissertations, and Capstones

Workplace violence is a common challenge seen in the healthcare settings across the world. This problem is steadily increasing in all types of hospitals, including a level one trauma center located in an urban area. There has been a steady rise in the number of assaults and workplace violence reported from bedside staff at this hospital. The leadership of the organization formed a work group to help combat the workplace violence and staff assaults that were occurring. In this process, a behavior response team was created to help nursing staff with escalating behavior in patients, and to help de-escalate the …

Telehealth, During Covid-19 Pandemic Did It Increase Access To Care?, Annette Allegra

Seton Hall University Dissertations and Theses (ETDs)

Abstract

The purpose of this project was to implement an Advance Practice Nurse-led Quality Improvement (QI) initiative to assess telehealth intervention during the Covid-19 pandemic and determine if it increased access to healthcare. This Doctor of Nursing Practice (DNP) project used interventions noted in the literature review to assess effectiveness and acceptance of telehealth use with psychiatric patients to increase access to healthcare in the setting of a medical center. Psychiatric patients often have poor compliance with healthcare visits and treatment due to the challenges of an inability to afford medications, transportation to appointments, poor community support and stigma to …

Implementation Of Nurse Navigators For Behavioral Health, Theresa Papagna

Seton Hall University Dissertations and Theses (ETDs)

Mental health patients have been notoriously non-adherent with diligent medication conformity, office visit fidelity, candor about side effects, use of illegal substances for self-medication, and truthfulness about co-occurring conditions. This non-adherence makes treatment difficult for psychiatric providers, and all those who participate in the care of patients with mental illness. Patient non-adherence can cause frustration and can lead to provider burnout, which affects patients as well as providers. Also, there are concerning financial implications of excessive time and resources needed to adequately monitor mental health patients. Implications regarding 30- day re-admissions are tantamount to consideration of financial strains put on …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

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 …

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 …