Psychiatric and Mental Health Nursing Commons^™

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.

Implementation Of Routine Screening To Detect Early Cases Of Depression And Anxiety In Hispanic Adolescents In The Primary Care Setting, Latoya Hayward

Doctor of Nursing Practice Projects

Depression and anxiety are among the leading causes of illness and disability in adolescents and are two of the most prevalent mental health conditions in Latino youth. If left unrecognized and untreated, these conditions can lead to decreased quality of life and increased rates of suicide. Researchers recommend early mental health screening to occur in the primary care setting. Through routine screening using evidence-based screening tools (PHQ-9 and GAD-7), the primary goal of this quality improvement project was to increase early detection of depression and anxiety in primary care and initiate early treatment. Project methods included implementation of new workflow, …

Occupational Stress In Psychiatric Nurses And The Impact Of Self-Care Activities, Jacqueline Lowe

Doctor of Nursing Practice Projects

Background

The nursing profession is an extremely stressful occupation. Psychiatric nurses face many of the general stressors that are inherent within the profession as well as unique challenges in taking care of psychiatric patients. Prolonged exposure to stress can impact the quality of the nurses' lives as well as the quality of patient care. Engagement in self-care activities can promote the well-being of psychiatric nurses.

Purpose

To investigate the level of occupational stress in psychiatric nurses and offer them a guided six-week program on self-care activities. This intervention was measured for any change in the level of occupational stress that …

Improving Depression Surveillance At The We Care Clinic, Kaitlin Springer, Emma Hanney

Doctor of Nursing Practice Projects

Depression is one of the most underdiagnosed and untreated disorders affecting more than 16 million people in the United States each year (Henry et al., 2020). Unmanaged depression can lead to emotional suffering, decreased productivity, reduced income, impaired relationships, and an increased risk for comorbidities (Sinisalchi et al., 2020). It can affect anyone, however, individuals who are non-white, female, undereducated, disabled, pregnant or postpartum, have low socioeconomic status, or lack social support are at an increased risk (United States Preventative Services Task Force, 2019). The Southern Illinois University Edwardsville We Care Clinic provides primary care to minority patient populations who …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …

Evaluating The Use Of Long-Acting Injectables As A Method To Improve Treatment Adherence In Patients With Schizophrenia: A Scoping Review, Britney Michelle Holton Msn, Fnp-Bc, Patricia Rena Jones-Purdy Msn, Cnrn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background Medication adherence is a major issue for patients suffering from schizophrenia and medication non-adherence can lead to psychiatric morbidity. Although long-acting injectable (LAI) antipsychotics have been shown to improve treatment adherence, most clinicians continue to rely on oral therapies to manage schizophrenia. This scoping review will assess evidence-based literature to determine the relationship between the use of LAIs and medication adherence in patients with schizophrenia.

Methods A literature review was conducted between August 2020 and January 2021 to find studies that have evaluated medication adherence with the use of long-acting injectables in patients with schizophrenia. Relevant literature initially selected …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

Boarding Barriers For Psychiatric Patients In Emergency Departments, Emmeline B. Martin Bsn, Rn, Alison Rossano Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Objective To identify past or current literature about emergency department holds and psychiatric patients consisting of the evaluation of patient outcomes, satisfaction and equity of care. It is already known that shorter boarding times from the emergency department to a psychiatric unit have positive patient outcomes such as a decrease in readmissions, increase in patient satisfaction and efficiency in appropriate treatment.

Method A scoping review to analyze data by grouping articles into themes which included authors, date of publication, aims/purpose, methodology, sample, interventional details, and the key findings in each article. Excluded articles included those discussing COVID-19 and case management. …

Impact Of Ante- And Postnatal Depression Screening In Women With Hiv: A Scoping Review, Kimberly M. Grider Bsn, Rn, Pmh-Bc, Bao Chau Le Bsn, Rn, Blessing Okon Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Maternal depression has been identified as a strong predictor of poor prenatal care. Among pregnant women living with Human Immunodeficiency Virus (HIV), mental health-related factors such as depression could potentially undermine effective antiretroviral therapy (ART) adherence, increase mortality, and cause poor HIV viral suppression consequently impacting vertical transmission of HIV. This scoping review aims to identify existing knowledge regarding the impact of ante- and postnatal depression screening in women with HIV and to adduce the necessity for effective screening.

Methods A literature search was performed for studies with primary outcomes of depression screening within the context of ante- or …

Sleep Deprivation And Delirium Development In The Icu, Cynthia Howell Msn Fnp-Bc, Stacy Murillo Msn Fnp-Bc, Amy Wilson Msn Fnp-Bc, Tracy Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Delirium is an acute syndrome characterized by disturbances in cognition occurring in critically ill patients, particularly those over 65 in the intensive care unit (ICU). Numerous risk factors are associated with delirium development, with sleep being a modifiable factor. This review explores existing literature regarding the relationship between sleep deprivation and delirium development while evaluating the effectiveness of a sleep promotion protocol to decrease the incident of delirium in those ICU patients 65 years or older.

Method A literature review of peer-reviewed studies from PubMed and additional search engines was completed. Articles reviewed were published within the last five …

A Scoping Review: Trauma Informed Care For Justice Involved Youth To Decrease Recidivism, Tamika Beecham, Marissa Gray, Shelby Husband, Diana Dedmon Dnp, Fnp, Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this scoping review was to address trauma-informed care, juvenile justice systems, and recidivism rates. The literature review conducted identified key research and analysis of effective trauma-informed treatment methodologies, referrals, and accessibility of care for justice-involved youth, and the rate change of recidivism related to trauma-informed treatment and interventions.

Background The high rates of recidivism in the juvenile court systems matched with the increased prevalence of psychological trauma in justice-involved youth represent the need for implementing trauma informed care. The scoping review analyzed the research implementing the intervention of trauma informed care to determine if it resulted …

The Impact Of Mindful Breathing On Stress Of Employees Working From Home, Lindsey Goldberg

Doctor of Nursing Practice Projects

This DNP project was designed to decrease stress among employees working from home (WFH) by educating them on mindful breathing practices. Through the implementation of a mindful breathing activity, the intended project outcome was to improve stress levels of employees working from their homes. Mindful breathing is an evidence-based strategy that has demonstrated decreased stress levels. Mindful breathing was implemented among two companies employing an estimate of 170 WFH employees to improve health and well-being with potential long-term positive impact on sustainability of organizations in the post-COVID, work from home environment. The participants were invited to perform 8-minutes of daily …

Medicated-Assisted Treatment And 12-Step Programs: Evaluating The Referral Process, Candace S. Brown, Chudney Williams, Ryan E. Stephens, Jacqueline Sharp, Bobby Bellflower, Martinus T. Zeeman

Doctor of Nursing Practice Projects

Purpose/Background Overdose deaths in the U.S. from opioids have dramatically increased since the COVID-19 pandemic. Although medicated-assisted treatment (MAT) programs are widely available for sufferers of opiate addiction, many drop out of treatment prematurely. Twelve-step programs are considered a valuable part of treatment, but few studies have examined the effect of combining these approaches. We aimed to compare abstinence rates among patients receiving MAT who were referred to 12-step programs to those only receiving MAT.

Methods In this prospective study, a cohort of participants from a MAT clinic agreeing to attend a 12-step program was compared to 15 controls selected …

Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C

Doctor of Nursing Practice Projects

Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.

Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …

Improving Suicide Risk Assessment Through Educational Program Implementation, Timothy Booth

Doctor of Nursing Practice Projects

Background: Unsustainable behavioral health education focused on comprehensive suicide risk assessment performance contributes to decreased registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients.

Purpose: To educate medical-surgical and progressive care registered nurses in assessing patients for suicide risk factors and warning signs comprehensively.

Design Method: A quasi-experimental designed quality improvement project with evidence-based suicide educational program implementation. Project results yielded a 56.7% increase in registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients. Future DNP work will focus on sampling a larger population (N) to decrease opportunities for the skewness of project results …

Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).

Methods We conducted a retrospective chart review on patients …

Implementing Best Practices To Improve Veteran’S Primary Care: A Pilot Project For Suicide Screening, Assessment & Referral, Nathaniel Held

Doctor of Nursing Practice Projects

Problem Description: Suicide is an increasing problem within the United States, but an even greater problem among the veteran population. Veterans are twice as likely to commit suicide than individuals within the civilian population. El Paso County, Colorado has the highest veteran population in the state and the highest number of suicides. Despite numerous military mental health programs available. Studies have found that many veterans will visit a civilian primary care clinic (for various reasons) within a month of taking their own lives but rarely are mental health concerns noted. This can be due to a lack of awareness and …

Efficacy Of Integrating Cbt For Mental Health Care Into Substance Abuse Treatment In Patients With Comorbid Disorders Of Substance Abuse And Mental Illness, Laura U. Madu, Jacqueline Sharp, Bobby Bellflower

Doctor of Nursing Practice Projects

Abstract: Multiple studies have found that psychiatric disorders, like mood disorders and substance use disorders, are highly comorbid among adults with either disorder. Integrated treatment refers to the treatment of two or more conditions and the use of multiple therapies such as the combination of psychotherapy and pharmacotherapy. Integrated therapy for comorbidity per numerous studies has consistently been superior to the treatment of individual disorders separately. The purpose of this QI project was to identify the effectiveness of Cognitive Behavioral Therapy (CBT) instead of current treatment as usual for treating Substance Use Disorder (SUD) or mental health diagnosis independently. It …

Improving The Quality Of Care For Pediatric Psychiatric Patients In The Emergency Department, Joseph L. Greene

Doctor of Nursing Practice Projects

Pediatric patients (17 years and younger) in mental health crisis are arriving in the emergency department in increasing numbers because there is a lack of mental health crisis care in the community setting. The emergency department is crowded, lacks a dedicated area for psychiatric patients that is quiet and safe, and staff are inadequately trained in psychiatric competencies. A quality improvement project was approved by Boise State IRB to train RNs in psychiatric competencies. Telepsychiatry provided timely evaluation by a qualified psychiatric provider. Patients’ perceived meaning of the ED visit was evaluated using the Patient Evaluation of Emotional Comfort Experienced …

Intervention Of Mindfulness With Students To Identify Mental Health Problems And Enhance Coping Strategies, Aileen M. Jones

Doctor of Nursing Practice Projects

When mental health care is delayed, a young person may have more difficulty in academia and social situations. Therefore, it is important to reach young people to provide them with the skills to deal with stressors and mental health issues. The purpose of this project is to use mindfulness techniques to increase mental health literacy (MHL) and strengthen coping skills which can possibly assist students in building resilience to cope with stressors. By utilizing available mental health resources and learning coping skills, there can be a drastic change in the trajectory of a young persons’ life who struggles with stressors …

Improving Psychological Trauma Awareness For Culturally Responsive Care: A Dnp Project, Jose M. Cruz

Doctor of Nursing Practice Projects

Racism and racial discrimination occur in a variety of forms (Kendi, 2017). Both can contribute to poor mental health outcomes in the United States (Alvarez, Liang, & Neville, 2016; Comas-Diaz, Hall, & Neville, 2019; Levy, 2019; Malott & Schaefle, 2015; Williams, Lawrence, Davis, & Vu, 2019). These social conditions have been identified as chronic stressors that can illicit trauma symptoms, result in post-traumatic stress disorder (PTSD), and contribute to increased suicidality (French et al., 2020). Providers should understand the ramifications of the psychological trauma that can occur and endeavor to deliver evidence-based solutions. This doctoral project was designed to develop, …

Minimizing Antipsychotic Medication Side Effects In Adults Diagnosed With Mental Illness Through Psychoeducation: An Evidence-Based Approach, Sarah A. Yao

Doctor of Nursing Practice Projects

Adherence to antipsychotic medication has demonstrated significant impact in decreasing symptom exacerbation among patients diagnosed with mental illness. Antipsychotic medications have several benefits including the management of psychotic and mood disorders; however, they could cause unwanted medication side effects with metabolic and cardiovascular risks. This issue is one of the commonly linked side effects resulting in nonadherence among mentally ill patients. The purpose of this project was to implement a psychoeducational intervention using the SIMPLE program to address metabolic and cardiovascular risks associated with antipsychotic medications among adult patients diagnosed with mental illness. A sample size of sixteen adult patients …

Implementing Safeplan: A Communication Template For Emergency Nurses Caring For Psychiatric Patients, Michele Leigh Rudisill

Doctor of Nursing Practice Projects

This DNP Project explored the impact of introducing a communication template for emergency department (ED) nurses to use during handoff when caring for psychiatric patients. This need was identified as ED nurses are now caring for psychiatric patients for longer periods of time in the ED setting, sometimes weeks to months, due to limited inpatient mental health resources and resources in the community. ED nurses’ perceptions were surveyed and the need for a standardized, yet flexible communication template was identified. The literature was reviewed, and no such template was identified specific to ED nurses caring for the psychiatric patient population. …

Awareness Matters: Improving Healthcare Workers’ Self-Efficacy, Knowledge, Skills And Attitudes Related To Mental Illness And Suicide Prevention, Carlana J. Coogle

Doctor of Nursing Practice Projects

Problem Description

Healthcare workers’ (HCWs) negative stigmas, poor attitudes, and lack of knowledge impact the care delivered to patients with a mental illness or who may be suffering with suicidal thoughts.

Rationale

Raising HCWs’ awareness, knowledge and skills have been linked to improving the negative stigmas, biases, and attitudes that impede the care required to achieve optimal health outcomes.

Intervention

Participants attended a 90-minute Question, Persuade, Refer (QPR) gatekeeper training, each participant received six bi-weekly emails about mental health issues, suicide prevention, and community resources. A pre/post survey design using the Mental Illness Clinicians’ Attitude Scale (MICA-4) and the Mental …

Using An Educational Session To Improve The Knowledge, Confidence, And Beliefs About Psychopharmacology For Behavioral Health Clinicians, Sharon Bennett

Doctor of Nursing Practice Projects

Background: Psychiatric illness is unpredictable, has spasmodic tendencies, and represents one of the most reported types of disabilities in the United States. Behavioral health clinicians are front line respondents and considered a major ally to providers by supporting medication management recommendations and referring new patients for medication management. Basic evidence-based psychopharmacology improves behavioral health clinicians’ knowledge, however, is inadequate in curricula, and many undergraduate and graduate programs lack one dedicated psychopharmacology class. This abbreviated knowledge contributes to inadequate referrals for treatment and poor confidence in supporting the practitioners’ medication recommendations.

Method: This project examined behavioral health clinicians’ knowledge, confidence, and …

Effects Of A Phase Ii Cardiac Rehabilitation Program On Patient Depression, Michael R. Legal, Dnp, Msn-Ed, Rn, Ccrn-K

Doctor of Nursing Practice Projects

Background: Screening for depression upon intake and completion of a Phase II cardiac rehabilitation (CR) program may influence the type of interventions implemented by CR staff and reduce depression.

Objectives: We examined patients before and after a Phase II CR program who self-reported as depressed using the CES-D score and also assessed scores by procedure, gender and age. We further identified the types of interventions used for those who were depressed.

Methods: We conducted a pre-post intervention study. Using a convenience sample, data were collected on CES-D scores before and after the program and by type of procedure, gender, and …

The Effects Of A Structured Teaching Session On Perceived Self-Efficacy Among Mental Health Nursing Supervisors, Pamela Fess, Dnp, Msn

Doctor of Nursing Practice Projects

Background: Specific factors that contribute to nursing supervisors perceived self-efficacy remains unclear. Although several studies have examined the relationship between self-efficacy and mental health nursing supervision most have focused on the impact of client care. To date, there is a dearth of studies to assess the impact of a leadership focused teaching session on the perceived self-efficacy of mental health nursing supervisors. Equipping nurses who are responsible for the supervision of others with the skills needed to fulfill their role responsibilities has the potential to improve their job performance, the work satisfaction, and well-being of staff nurses they supervise as …

Pilot Study Of Anxiety, Depression, And Quality Of Life In Patients With The Diagnosis Of Metastatic Uveal Melanoma, Regine Nshimiyimana, Dnp, Bpharm, Fnp-Bc, Agacnp-Bc, Ocn, Aocnp

Doctor of Nursing Practice Projects

Background: Awareness of a patient’s anxiety, depression, and quality of life (QOL) in those with metastatic uveal melanoma (MUM) can influence care that meets patients’ bio-psychosocial-spiritual needs.

Objectives: To measure the level of anxiety, depression, and QOL in patients with MUM and explore differences by gender, age range, time to metastatic disease, and duration of illness since metastasis.

Methods: We used a descriptive-comparative survey design. Over three months, a convenience sample of 70 patients with MUM aged ≥ 18 years, treated at a Mid-Atlantic hospital were invited to complete a combined survey of the Hospital Anxiety and Depression Scale and …

Developing Psychiatric Nursing Competencies On An In-Patient Hospital-Based Psychiatric Unit, Beverly J. Sedlacek

Doctor of Nursing Practice Projects

Problem Statement

Offering staff development training for psychiatric nurses has not kept pace with the advances in psychiatric knowledge and skills in nursing. Purpose: The purpose of this quality improvement doctor of nursing (DNP) project was to implement a competency-based staff development program on a community hospital-based inpatient psychiatric unit to determine if the psychiatric/mental health nursing knowledge, nurse patient relational skills, and attitudes of the nurses would improve or change.

Methods

A mixed method of quasi-experimental, non-randomized pre-test/post-test and semi-structured interview design was used, which utilized a convenience sampling approach. Data were collected in two phases. Three domains of …

Implementing An Intervention To Reduce Seclusion And Restraints In An Inpatient Psychiatric Hospital, Amanda B. Lykins

Doctor of Nursing Practice Projects

The need to enhance nursing staff’s knowledge, perceptions and attitudes around alternatives to seclusion and restraint has been well validated in the literature. Seclusion and restraint use in the inpatient psychiatric setting are highly dangerous physical interventions, used to control the behavior of a mentally ill patient who is a danger to self or others. Seclusion and restraint events have the potential to cause emotional trauma, physical injury to patients or staff and the possibility of patient death. The purpose of the capstone project was to implement an evidence-based education program to, improve nursing staff’s (RN, LPN, MHA and SRNA) …