Psychiatric and Mental Health Nursing Commons^™

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

DNP Projects

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

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

DNP Projects

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

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

DNP Projects

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

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

DNP Projects

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

Evaluation Of Self-Efficacy And Confidence Levels Among Newly Graduated Nurses Exposed To An End-Of-Life Simulation: A Comparison Study, Catherine Edwards

DNP Projects

Purpose: The purpose of this project is to compare self-efficacy and confidence levels among a cohort of newly graduated nurses (defined as nurses who have had no nursing experience and are participating in a new graduate nursing residency) who will participate in an EOL simulation with another cohort of nurses who have been practicing for a year or more, but have not participated in an end-of-life simulation.

Methods: The study included two parts. The first portion included a pre and post-test evaluation of an end-of-life (EOL) simulation intervention with newly graduated nurses (Group One, n= 22), as part of their …

Assessment Of Alcohol Withdrawal Syndrome Incidence And Identification Of Other Correlating Risk Factors In Patients Admitted Through The Emergency Department, Hannah Young

DNP Projects

PURPOSE: The purpose of this project was to measure adherence rates to the current alcohol use screening process, and identification of correlations of alcohol use and outcomes in patients admitted to Norton Hospital, via the emergency department.

METHODS: The study design is a retrospective descriptive evaluation, of adherence to the current alcohol use screening process, and associations among age, gender, ethnicity, length of stay, number of ICU days, restraint use days, level of care at admission (ICU, TCU, LLM/tele, MS), incidence of AWS/DTs, and activation of the CIWA protocol among the adult inpatient population of Norton Hospital’s downtown campus, admitted …

Tne Effect Of In Our Own Voice On Stigma In Bsn Students, Stephanie Steele

DNP Projects

Stigma regarding mental illness is common throughout the world, and can lead to social isolation, low self-esteem, loss of income and employment, deterioration of life quality, impeded access to medical care, and a shorter lifespan for people diagnosed with a mental illness (Cleary, Deacon, Jackson, Andrew, & Chan, 2012; Corrigan et al., 2013). The purpose of this DNP project was to provide an evidence-based intervention called In Our Own Voice (IOOV) to first semester sophomore nursing students and assess its impact on their perceptions of mental illness stigma. Alterations in stigma were assessed through the Attribution Questionnaire-27 administered to students …

Evaluation Of The Crafft Substance Use Screening Tool In Primary Care, Leanne Coleman

DNP Projects

PURPOSE: The purpose of this research study was to evaluate the use of the CRAFFT tool within a pediatric primary care setting. The specific objective was to assess the frequency of documentation of substance use screening, counseling, and/or intervention before and after the implementation of the CRAFFT tool.

METHOD: The practice site chose to implement an evidence based adolescent substance use screening tool (CRAFFT Tool) to improve practice. This practice improvement project utilized a descriptive design with a review of electronic medical records before and after a substance use screening tool was implemented. Two hundred medical records were reviewed, 100 …

The Effect Of Mindfulness Meditation On Perceived Stress And Total Health Care Cost, Rachel Hale

DNP Projects

Background: Chronic stress can lead to hypertension, tachycardia, and increased inflammatory markers, which put individuals at risk for chronic diseases. Mindful meditation not only decreases perceived stress but also has the potential to decrease the risk of chronic diseases and health care cost. Purpose: The purpose of this mindfulness meditation project is to reaffirm that mindfulness meditation decreases perceived stress scores and to determine whether mindfulness meditation decreases health care cost. Theoretical Model: The relation of mindfulness meditation, lowered stress levels, and chronic diseases can be explained by the social cognitive theory (SCT). Applying SCT, meditation’s goal is to alter …

Perceptions About Cognitive Enhancement Therapy Among Regional Mental Health Providers: A Mixed Methods Analysis, Adam A. Loose

DNP Projects

Cognitive Enhancement Therapy (CET) is a program, developed at the University of Pittsburgh, to improve cognitive deficits experienced by people diagnosed with schizophrenia. Since its implementation in various settings, CET has demonstrated positive outcomes for patients in many cognitive domains. This study took a mixed methods approach to assess the interest and knowledge of mental health providers at a regional level and a local mental health facility in particular, about beginning a CET program. The quantitative study obtained data from evaluations administered during two CET training events at a local mental health facility. Digitally recorded qualitative interviews were conducted with …

Screening For Alcohol Use/Abuse In The Primary Care Setting Using The Audit-C And Sbirt (Screening, Brief Intervention, Referral To Treatment), Whitney D. Spear

DNP Projects

PURPOSE: The purpose of this study was to examine the feasibility of alcohol screening in the primary care setting to detect alcohol abuse or misuse using the AUDIT-C standardized screening tool and SBIRT.

METHODS: This study design was a Quasi-Experimental intervention, one group post-test. Data was collected via retrospective chart review from the electronic medical records by the type of office visit; either new patient initial visit or annual well visit. The patient sample consisted of 25 participants for the study period of September 19^th through October 10^th, 2017.

RESULTS: There were 37 patients eligible to participate …

Evaluation Of The Healthy-Heart, Healthy-Brain Program, Sooksai Kaewbua

DNP Projects

Purpose: The purpose of this study was to evaluate the effects of a group-based, psychoeducational program on the knowledge of healthy diet and eating behaviors of adults with mental-health diagnoses in an inpatient psychiatric setting.

Background and Significance: In a given year, adults with mental-health diagnoses have a higher risk of mortality relative to the general population. Mortality from natural causes among individuals with mental-health disorders is similar to the leading causes of death found nationwide, including cardiovascular diseases. There is a growing body of evidence showing a relationship between the health of clients’ hearts and brains. Thus, it is …

A Secondary Analysis Of Survey Data Evaluating The Lifelines Suicide Prevention Program Among Middle School Students, Nicki Sullivan

DNP Projects

PURPOSE: The purpose of this study was to evaluate student feedback of the 2015 Lifelines Suicide Prevention Program at Jessie Clark Middle School. Student feedback was examined by assessing students’ knowledge of suicide, attitudes toward suicide, knowledge of when and from whom to seek help if feeling suicidal or told by a friend that they are suicidal, and impressions of the educational presentation following participation in the Lifelines Suicide Prevention Program.

METHODS: In this secondary analysis, anonymous student responses (N=269) from a 2015 middle school survey were examined by using a mixed method design with the quantitative study measures being …

Evaluation Outcomes Of Delirium And Abrupt Discontinuation Of Psychiatric Medications Of The Adult Acute Care Patient, Latoya Lee

DNP Projects

PURPOSE: Delirium remains a common consequence of critical illness and is known to cause negative patient outcomes during an intensive care unit (ICU) stay. Hence, the purpose of this project is to evaluate the outcomes of patients taking psychiatric medications whose medications are abruptly discontinued upon admission to an ICU. Specifically, the outcomes of interest will be altered mental status, length of hospital stay, restraint use and mortality.

METHODS: A correlational analysis using a retrospective chart audit was conducted on 602 patients admitted to the Neurological/ Neurosurgical ICUs at the University of Kentucky Chandler Hospital from January 2015 to December …

Patient Characteristics Associated With Inpatient Psychiatric Re-Admissions And The Utility Of The Readmit Clinical Risk Index, Autumn P. Roque

DNP Projects

In response to the problem of frequent 30 day re-admissions to inpatient psychiatric facilities, Vigod and colleagues (2015) developed the READMIT clinical risk index to identify risk factors for psychiatric inpatient re-admissions. The question addressed in this study was: Can the READMIT clinical risk index be used to identify patients that are at high risk for 30 day inpatient psychiatric re-admissions at Eastern State Hospital? This project used a descriptive retrospective design. Data were extracted from the discharge summaries of patients discharged from Eastern State Hospital between September 2013 and December 2014. Data collected included patient demographic variables (age, gender, …

Use Of Simulation Involving Standardized Patients As An Education Program To Increase Nurse Confidence In Caring For Patients With Drug And Alcohol Problems, Brandy G. Mathews

DNP Projects

Purpose: The purpose of this pilot project was to test the effectiveness of a simulation exercise using standardized patients on nurses’ perceived confidence in caring for patients with drug and alcohol problems.

Method: The project was a mixed methods pre-test and posttest design to assess whether simulation using standardized patients was effective in improving nurses’ confidence in caring for patients with problematic drug and alcohol use issues. Qualitative data was obtained by interviewing participants using a semi structured interview.

Results: All nurses reported a positive experience as a result of participating in the simulation exercises. Use of simulation as …

Examining Provider Perspectives On Implementation Of An Integrated Primary And Behavioral Health Care Model In The Outpatient Setting: A Qualitative Study, Holly Gray

DNP Projects

AIM The purpose of this qualitative descriptive research study was to identify and describe primary and mental health provider perspectives, including attitudes and knowledge related to integration of primary and behavioral health care in the outpatient setting. One objective of this project was to gather information from providers in both primary and behavioral health settings to ascertain how they perceive the idea of integrated care. Another objective of this project was to gather information about provider perception of current practice protocols for treatment of patients with comorbid physical and mental health issues, perceived facilitators and barriers to integrated care, and …

Treatment Outcomes For Opiate Addicted Pregnant Women, Jennifer L. Roth Parr

DNP Projects

The problem of opiate addiction is complex enough but compounded when the patient is pregnant. Substance use during pregnancy produces harmful and costly effects to both the mother and the fetus (Veilleux, Colvin, Anderson, York & Hines, 2010). The rate of opiate addiction among pregnant women in the U.S. has been increasing in epidemic numbers since the beginning of the 21st century. This paper looks at research on the origin of the problem, the demographics of the average pregnant opiate addicted patient, the effects on the woman and her unborn child, and available treatment options.

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Adolescent Risk Behaviors, Screening, And Referral At An Adolescent Health Clinic: A Retrospective Review, Cheryl Marrs

DNP Projects

Aim: Investigate provider patterns of risk behavior screening at an adolescent health clinic and describe findings from a study that investigated patterns of risk behavior screening in an adolescent health clinic.

Background: Adolescents who engage in risky behaviors are vulnerable to problems with current and future mental health issues such as depression, substance use, or other psychiatric disorders. Identifying the risky behaviors in adolescents that are associated with the potential presence of depressive symptoms can be helpful to the provider when deciding to refer an adolescent for further mental health assessment. Provider fidelity in risk behavior screening is central to …

Delirium Screening Instrument Knowledge And Perception Among Cardiovascular Intensive Care Nurses, Brittany Lynn Dahl

DNP Projects

Background: Delirium is a serious condition that affects critically ill adult patients in the intensive care unit. Bedside nursing delirium measurements are considered a dependable source of information that can be used for clinical decision-making. Nurse education and assessment of perceptions is important when building a framework for successful delirium assessment. However, few data exist about nursing perceptions and practices associated with delirium screening instruments. The overall purpose of this project is to examine nurse perceptions and knowledge about delirium and delirium screening instruments at the University of Kentucky (UK) Hospital’s Cardiovascular Intensive Care Unit (CVICU).

Objectives: The aims of …

Implementation Of A Depression Screening Protocol Specific To Implantable Cardioverter Defibrillator Patients; A Quality Improvement Project, Kendra M. Kratzwald

DNP Projects

Background: Depression in patients with implantable cardioverter defibrillators (ICD) is a problem that has not been well addressed by providers. In 2012 the American Heart Association (AHA) released a scientific statement that recommended structured and routine depression screening of these patients. The AHA statement also recommended further research on depression screening instruments and their use with this population. Aims: 1.) To develop and implement an evidenced based depression screening protocol appropriate for patients with an ICD seen in an outpatient setting. 2.) Evaluate provider knowledge about depression screening (? Is this what you mean) and depression screening practices before and …

Evaluation Of Depression Screening Practices For College Women In A Primary Care University Health Clinic, Sarah E. Lester

DNP Projects

Mental disorders, including depression, are increasing in frequency and intensity in the college student population. College-aged women appear to be particularly vulnerable to depression. Primary care providers play an important role in addressing this issue, as they are the principal health care contacts for more than 50% of patients with mental illnesses. Guidelines from the 2009 United States Preventative Services Task Force recommend screening all adults (age 18+) for depression in primary care when depression care supports are in place. However, current screening rates for depression in the primary care setting from are estimated at only 1.6 to 3.3% (United …