Psychiatric and Mental Health Nursing Commons^™

Integrating Matrescence Into Birth Worker Practice: A Practice Improvement Project, Kelsey B. Green

Doctor of Nursing Practice (DNP) Projects

Background: Perinatal mood and anxiety disorders (PMADs) affect 20–25% of mothers worldwide and are a leading cause of maternal complications. Stigma, fragmented care, and limited provider training leave families vulnerable, while birth workers offer trusted, continuous support.

Problem: Birth workers' maternal mental health (MMH) training is minimal and often excludes matrescence, the developmental transition to motherhood, limiting their ability to distinguish normal adjustment from clinical PMADs and delaying intervention.

Methods: A single-group, pre-/post-test design evaluated a matrescence-informed workshop at Roots Community Health's 2nd Annual Symposium. Anonymous surveys measured knowledge, attitudes, and confidence, analyzed with Mann–Whitney U, Wilcoxon signed-rank tests, and …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

From Fear To Familiar: Decreasing Technology Anxiety Among Older Adults In A Senior Community, Regina Rayz

Master's Projects and Capstones

Objective: Older adults (defined by the WHO as those 65 and older in developed countries) are more susceptible to technophobia than younger adults (Song et al., 2025). The fear and anxiety occurs with use of smartphones, tablets, social media, and telehealth and is associated with higher rates of social isolation and reduced autonomy. Technology-use anxiety is a preventative obstacle that inhibits both technology acceptance as well as overall health (Kim et al., 2023). Aim: To reduce technology-related anxiety among older low-income adults living in a senior residential facility in Richmond, CA by at least 25% using a brief, individualized technology …

Charting The Course: Improving Psychotropic Medication Documentation Through Staff Education To Promote Patient Safety And Cms Compliance, Anne J. Bertram Rn

Master's Projects and Capstones

The University of San Francisco master’s level nursing program culminates with a clinical nurse leader (CNL) quality improvement project. The objective of this project is to reinforce the program’s didactic CNL classes by allowing students the opportunity to design, implement, and analyze a quality improvement project in a microsystem. SETTING: Skilled nursing facilities often prescribe psychotropic medications to help manage residents’ behavioral and psychological symptoms. Due to the possibility of side effects and increased sedation, there are concerns for patient safety and quality of life. Inadequate management of these patients and symptoms compromises patient safety and breaches state and federal …

From Fear To Familiar: Reducing Technology-Induced Anxiety In Seniors, Justin Kyle V. Manalang

Master's Projects and Capstones

Abstract

This quality improvement project focuses on reducing the average technology-induced anxiety score among senior community members through 1:1 mentorship sessions. Aim During an eight-week period from September 10, 2025, to November 5, 2025, this project will reduce the severity of technology-induced anxiety by 25% from the established baseline. Methods: A 5P Microsystem assessment was conducted alongside an initial questionnaire to gauge the residents’ interests and concerns regarding technology use. From the results, focused mentorship sessions were conducted once a week and pertained to the chief complaint the resident had for eight weeks. The mentorship sessions were one-to-one and individualised …

Matrescence: An Emerging Concept For Birth Worker Practice, Kelsey B. Green

DNP Qualifying Manuscripts

The maternal mental health (MMH) crisis, affecting up to 25% of birthing individuals, is exacerbated by significant gaps in perinatal support. While birth workers are uniquely positioned to provide care, they often lack specialized training beyond basic screening checklists to address the complex transition to motherhood, defined as matrescence. This clinical innovation proposal outlines a matrescence-informed educational curriculum, guided by the Comprehensive Model of Mental Health during the Perinatal Period. The intervention is designed to build tangible, implementable skills, training birth workers to: (1) operationalize matrescence as a psychoeducational tool to normalize distress; (2) use clinical differentiation to distinguish the …

Trauma-Informed Family-Centered Care Training For Neonatal Intensive Care Nurses, Sonja A. Alli-Casella

Doctor of Nursing Practice (DNP) Projects

Background The neonatal intensive care unit (NICU) is a high-stress environment that can cause or exacerbate emotional trauma for parents of critically ill infants. While NICU nurses are trained in neonatal care and basic family-centered principles, they often receive limited education on supporting adults in acute emotional distress, leaving them unprepared to manage dysregulated behaviors. Local Problem At a Level IV NICU in a Southern California pediatric hospital, nurses may underestimate their influence on parental stress levels due to a lack of formal training in supporting emotionally distressed adults. Methods A comprehensive literature review informed an evidence-based practice (EBP) initiative …

Empowering Schools: Suicide Prevention Education For School Nurses, Navjot K. Singh

Doctor of Nursing Practice (DNP) Projects

Background: Suicide among adolescents and youth is a serious public health issue that requires immediate intervention to reduce ideation and death. The increasing rate of suicide among children and adolescents has a profound effect on families, friends, and the community.

Problem: Suicide among school aged children and adolescents can create significant challenges for school nurses, who are often the first contact for students who recognize suicidal ideation and mental health crises. This issue is particularly significant for the Alameda school nurses in California, as they play a significant role in identifying and supporting students in a crisis.

Methods: A …

Thinking Long-Term: Nursing Education On Long-Acting Injectable Antipsychotics, Arslan Amir Rashid

Doctor of Nursing Practice (DNP) Projects

Background Schizophrenia cases and their associated healthcare costs have drastically increased over time in the United States. Antipsychotic nonadherence is a primary contributor to the high rates of relapse and rehospitalization among adult patients with schizophrenia. The development of long-acting injectable antipsychotics (LAIs) has positively impacted medication adherence, however, this treatment modality is still underutilized in practice due to barriers, such as physician and patient negative attitudes toward LAIs and lack of education. Nurses hold a unique position to potentially change practice and address some of the barriers to LAI usage. Local Problem A Mental Health Rehabilitation Center in California …

Intimate Partner Violence Prevention And Intervention At A Primary Care Clinic, Atticus Madrid

Master's Projects and Capstones

Abstract

Intimate partner violence (IPV) is a massive health concern in the Spanish-speaking community. There is a high rate IPV, worsening by factors such as language barriers, cultural stigma, and the constant fear of deportation. Resent data underscores the need for standardized IPV screening and trauma-informed care, thus supporting early recognition and intervention. The aim of this Quality Improvement (QI) project is to increase IPV detection rate by 25% from March 10, 2025, to April 15, 2025, in an San Francisco community clinic using an electronic tool called a HITS (Hurt, Insult, Threaten, Scream) and by trauma-informed staff training. Methods …

Empowering Schools: Suicide Prevention Education For School Nurses, Navjot K. Singh

DNP Qualifying Manuscripts

Introduction: Suicide among adolescents and youth is such a serious issue that immediate, appropriate interventions are needed to reduce rates of suicide ideation and suicide mortality. The increasing rate of suicide among this population profoundly affects families, friends, and the community. Identifying and implementing appropriate interventions in schools could identify individuals who are suffering from mental illness and support suicide prevention.

Aim: The purpose of this integrative literature review was to examine the literature on suicide prevention interventions for young adolescents and teenagers aged 12-17 years old and identify the best, evidence-based practices for the school setting. The aim …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

Stress Management Education Module For Nursing Students, Valentina Loreto-Ashley

Doctor of Nursing Practice (DNP) Projects

Abstract

Background. Stress refers to a state of mental tension caused by a difficult situation. Research indicates that stress negatively affects university students.

Problem. Researchers have found that 30% of undergraduate nursing students have symptoms of burnout resulting from an overaccumulation of stressors and 97.8% were at moderate risk for developing burnout.

Approach. An educational module consisting of a 15-minute YouTube videos was designed, developed, and implemented to increase awareness about stress, reduce feelings of anxiety, and identify integration potential of such a module in nursing education to promote student well-being. Participants completed an online survey before …

Implementation Of A Daily Engagement System Board (Desb) To Improve Hospital Staff Communication, Catherine Villanueva

Master's Projects and Capstones

Implementation of a Quality Improvement (QI) project to help improve staff communication between shifts at an Inpatient Acute Psychiatric Unit was determined to be of immense need. This unit is part of a large acute medical hospital. Currently, the end of shift report consists of a verbal report along with a robust printed end of shift report consisting of shift related information. This printed end of shift report can have as many as seven to nine pages thus causing information overload and decreases prioritized patient information. Furthermore, missed information or too much information can be provided in the verbal shift …

Developing A Trauma-Informed Family-Centered Care Toolkit For Neonatal Intensive Care Unit Nurses, Sonja A. Alli-Casella

DNP Qualifying Manuscripts

Background: The neonatal intensive care unit (NICU) may be a stressful, traumatizing, or re-traumatizing experience for parents of critically ill newborns and infants.

Problem: NICU nurses and other healthcare providers may not realize their impact on parental stress responses as neonatal care providers may not have adequate training to support adults experiencing acute emotional distress.

Methods: Strong evidence supports using family-centered care (FCC) in the NICU to promote bonding and parental involvement in caring for their infants. This manuscript aims to review current research and literature on trauma-informed care training and its impact on nurse confidence in managing dysregulated adults, …

Trauma-Informed Care: A Therapeutic Approach In Communication, Nicole A. Leonce

DNP Qualifying Manuscripts

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Improving Firefighter Health Through Education In Sleep Science, Elisabeth J. Filiss

Master's Projects and Capstones

Sleep impacts all aspects of life, from mental health to physical well-being to job performance. Nowhere is this more important than in the fire service, where extreme working conditions are the norm. One of 44 stations in a large fire department (XFD), Firehouse X, has 21 full-time members, six on duty per shift. A microsystem assessment of Firehouse X revealed poor sleep habits and environmental factors that are not conducive to quality sleep. The role of sleep in the fire service has recently been examined, and interventions aimed at improving firefighters’ sleep have been recommended.

This quality improvement project implemented …

Fostering Interprofessional Collaboration In Community College Mental Health Centers: A Quality Improvement Project, Sara Jane Hamilton

Doctor of Nursing Practice (DNP) Projects

Background The worsening mental health rates among college students in the United States highlight the critical need for campuses to have high-quality comprehensive mental health centers (MHC). This necessity is particularly urgent in community college MHCs, which often lack these attributes. Local Problem An MHC within a large California community college recently introduced telepsychiatry services and is considering integrating a Psychiatric Mental Health Nurse Practitioner (PMHNP) into their team. However, knowledge gaps and limited interprofessional education (IPE) may hinder effective collaboration within the team. Methods A comprehensive literature review was conducted to assess current research on IPE, community college mental …

Enhancing Mental Health Assessments For Hysterectomy Patients: Implementing A Depression Screening Tool For Healthcare Clinicians, Dede Mihedji

Doctor of Nursing Practice (DNP) Projects

Background: Hysterectomies are prevalent in the United States ranging from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing preoperative depression could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy. Local Problem: Currently, there is no standard practice for preoperative depression screening in hysterectomy patients. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). Methods: To address the gap, clinicians attended a fifteen-minute Zoom course on the Patient Health Questionnaire 9 (PHQ-9) and its …

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 …

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). …

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 …

Implementation Of An Implicit Bias Training In A Doctor Of Nurse Practitioner Program, Macdana Selecon

DNP Qualifying Manuscripts

Background: Implicit bias in healthcare delivery is the unconscious prejudice individuals might feel about another person or group. All healthcare providers are susceptible to implicit bias which can negatively influence patient-provider communication. Implicit bias is linked to disparities in maternal health outcomes. According to the CDC, the maternal mortality rate for non-Hispanic Black women is 2.9 times higher than the rate for non-Hispanic White women (Hoyert, 2022).

Problem: Implicit bias (IB) training is not provided in all graduate nursing programs. As a result, graduate nursing students are not prepared to manage IB during clinical rotations and post-graduation, thus, are at …

Trauma-Informed Treatment For Alcohol Use Disorder: Improving Long-Term Recovery, Aline M. Bales

Doctor of Nursing Practice (DNP) Projects

Background: This DNP project aimed to assess the feasibility of implementing trauma-informed care to Ria Health's telehealth AUD MAT recovery treatment model for patients with co-occurring PTSD, targeting high relapse rates due to cravings. Trauma-informed care addresses traumatic histories that can potentiate emotional dysregulation leading to maladaptive coping responses manifesting as cravings with addiction memory.

Methods: An integrated review assessed the prevalence of co-occurrence of AUD and PTSD, assessed interest in Ria Health patients, patients recruited from Ria Health if they mentioned cravings, offered concurrent trauma-informed care with medicated assisted treatment for 16-20 sessions, trauma-informed care used Polyvagal Theory techniques …

Save The Children Community Health Worker Program – Adverse Childhood Events Prevention, Jieun Lee

Doctor of Nursing Practice (DNP) Projects

Background: Adverse childhood experiences (ACEs) are potentially traumatic events that occur between the ages of 0 to 17 in which are directly associated, in a dose–response manner, to many of the most common and serious health problems in the United States.

Local Problem: 62% of California residents have experienced at least one ACE, and 16% have experienced at least four ACEs. ACEs are linked to nine of the ten leading causes of death in the United States Adults with four or more ACEs are 37.5 times more likely to attempt suicide, 3.2 times more likely to have chronic lower respiratory …

Mental Health Services: Reaching The Homeless, Gurdeep Mann

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Serious mental illness (SMI) and substance use disorder (SUD) are two common findings among the majority of those experiencing homelessness in the Stanislaus County.

Local Problem: Emergency shelters typically do not provide mental health services on-site, however, a collaboration between First Behavioral Health Urgent Care Center (FBH) and We Care Program Turlock (WCPT) was established to provide mental health services on-site.

Method: The WCPT case manager as part of a Doctor of Nursing Practice (DNP) quality improvement project implemented Assertive Outreach Model interventions to increase utilization of mental health services and established long-term relationships.

Interventions: Frequent contact with …

The Use Of Therapeutic Gardening In Addiction Recovery, Sophia Agne

Master's Projects and Capstones

Problem: Numerous recent studies have emerged detailing the benefits of horticultural therapy on mental health and wellness. Despite this, substance use disorder treatment facilities rarely include an outdoor component in their programming. The project seeks to examine the advantages of incorporating therapeutic gardening as a complementary part of addiction treatment.

Context: The microsystem where the study was conducted was at a 32-bed residential substance abuse treatment facility for adult men who have previously been involved in the criminal justice system. The treatment approach employed at the facility aligns with the Integrated Dual Disorder Treatment (IDDT) curriculum, which emphasizes mental health-informed …