Psychiatric and Mental Health Nursing Commons^™

School-Based Suicide Prevention Program Implementation: Improving Awareness Among Parents And Faculty, Nicole Neuman

Doctor of Nursing Practice (DNP) Projects

The health development and critical transition period of preteen to adolescence are subject to adverse experiences and prevalent risk behaviors that may negatively influence mental health. Emerging issues of depression and suicide among school-aged youths present a global epidemic. Well-designed interventions, such as school-based programs, align with national strategies and health initiatives to reduce suicide rates and facilitate treatment of concerning symptoms. Database searches for school-based, suicide, depression, prevention, and screening literature from 2012-2017 identified 12 relevant studies selected for review. Mental wellness and suicide prevention curricula must successfully improve wisdom, enhance coping skills/resilience, and foster relationships which support help-seeking …

Reexamining Overuse Of Frequent Observation For New Admissions On Psychiatric Units To Increase Nurse/Patient Engagement, Samuel Novela

Master's Theses

People in California who suffer from mental health conditions are often admitted involuntarily to hospitals on 72 hour psychiatric evaluation holds if they are deemed imminently dangerous to themselves, or others, or are gravely disabled. Observational patient safety checks are performed and based on patient acuity and hospital standards. Variations exist among different clinical settings with regard to best practices and the patient subpopulations that may warrant less frequent safety checks. Nurses experience different levels of satisfaction with regard to frequency of safety checks because there is no national consensus on which subsets of patients may require them. A senior …

Suicide In High School Students And The Effectiveness Of State Suicide Prevention Plans, Patricia G. Wilson

Nursing Theses and Dissertations

With suicide rates rising across all demographics and regions in the U.S., suicide prevention is one of the most challenging public health issues in recent history. Because of its prevalence, the number of federal agencies and national organizations involved with suicide prevention activities is at an all-time high (Office of the Surgeon General & National Action Alliance for Suicide Prevention, 2012). Instituted in 2001, the National Strategy for Suicide Prevention (NSSP) was revised in 2012 and serves as a guide for states in the fight against suicide through its strategies, goals, and objectives (Office of the Surgeon General & National …

A Quality Improvement Initiative To Implement The Geriatric Depression Scale In A Geriatric Inpatient Psychiatric Unit, Candice Hall

Doctor of Nursing Practice

The World Health Organization (2017) estimated that over 300 million people worldwide have depression. According to the Centers for Disease Control and Prevention (2013), 7 million Americans over 65 years old experience depression annually. The United States Preventive Health Services Task Force recommends the use of a depression screening tool in the adult population. The purpose of this evidence-based quality improvement project was to improve screening for depression in an inpatient geriatric psychiatric unit. The primary objectives included educating nursing staff on depression screening and using the geriatric depression scale (GDS) to assess patient's level of depression at admission and …

Evaluation Of Short Term Cognitive Behavioral Therapy Intervention In A Primary Care Setting, Kevin Hengeveld

Doctoral Projects

Introduction: Depression and anxiety are chronic recurring medical conditions that impact all aspects of health. When depression and anxiety are present with other comorbid diseases, mortality and health care costs are higher. Children and young adults are particularly vulnerable to mental health issues. Suicide is the 2nd leading cause of death for this demographic. Depression is common in adolescents with an incidence of 8 to 20 percent. Primary care provides 70 percent of mental health care in the United States, and the primary intervention offered is pharmacological. Evidence suggests that a combination of medication and psychotherapy provide superior relief of …

Assessing Readmission Risks In Adolescent Psychiatric Patients, Keyamo Omokuru

Doctor of Nursing Practice

Purpose: Assess risk of readmission of adolescent patients to an inpatient psychiatric unit within 30-days post-discharge by using a clinician-rated behavioral health outcome assessment measure to rate psychiatric patient. Background: In the United States, approximately four million adolescents suffer from mental disorders. When admitted for inpatient psychiatric care, approximately 13% of adolescent mental health patients are readmitted within 30-days, 25% within one year, and 81% within 90-days, of inpatient psychiatric admission. Methods: An evidence-based quality improvement project that utilized the clinician-rated behavioral health outcome assessment tool called the Health of the Nation Outcome Scale for Children and Adolescent (HoNOSCA). The …

Improving Postpartum Depression Screening And Treatment Referral Rates In An Ob-Gyn Clinic, Ciddet Abrahams

Doctor of Nursing Practice

Abstract

Background: Up to 25 % of adult women are diagnosed with postpartum depression. This diagnosis may also lead to poor health outcomes for the mother and the infant. Four out of five women with a positive screening for postpartum depression do not receive care from a mental health provider.

Purpose: The purpose of the project was to improve postpartum depression screening and follow-up care to mental health services in a clinic providing obstetrical and gynecological care in the central Texas area.

Objectives: The primary objective of the project was to increase postpartum depression screening rates. The second objective was …

Depression Screening At A Mental Health Outpatient Clinic: A Quality Improvement Project, Renee Licorish

Doctor of Nursing Practice

Project Background: Depression is one of the most common mental health problems in the United States. Many individuals may seek treatment but go undiagnosed due to the lack of recognition by clinicians. Clinical guidelines recommend the use of a standardized depression screening tool within a clinician’s evaluation process. The Patient Health Questionnaire 9 (PHQ-9) is such a tool and recommended for use in the outpatient care setting. Aims of the Project: To increase depression screening of clients at a hospital-based outpatient behavioral health clinic. Purpose and Objectives: Implementation of the PHQ-9 into the clinic’s mental health assessment process to increase …

Quality Improvement On Depression Protocols In The Military Training Environment, Priscilla R. Colunga

Doctor of Nursing Practice

Background: Active Duty military members are highly susceptible to depression and suicide due to separation from family during training and deployments, exposure to traumatic experiences in combat, and loss of friends during combat.

Purpose and Objectives: Depression and suicide remain a high priority among military personnel. This process improvement project aimed to improve the rate of depression screening and improve the assessment, treatment, and management of soldiers with depression in a primary care setting to prevent disease progression while waiting to be seen by a behavior health specialist.

Interventions: During the 6-week time frame, all active duty military and reservists …

Stigma For Caring For Those With Mental Health Issues In The Student Nurse Community: A Survey, Matthew Boyd

Undergraduate Honors Theses

People living with a mental health issue is elevated both nationally and internationally, and the likelihood of a person interacting with someone who has a mental health issue is high. It is even higher for those who work in the health care profession, so understanding their attitudes on this matter is important. As a review of current literature reveals, there is not only stigma in the health care system, but there is also stigma among health care professionals and students. One of the groups of students that has not been researched to a great extent is nursing students and the …

Searching For Wisdom: A Phenomenological Investigation Of Women's Perspectives Following Participation In An Ovarian Cancer Supportive Care Group, Helen Butlin

Electronic Thesis and Dissertation Repository

This study used a novel methodology of hermeneutic-poetic-phenomenology to explore perspectives of women living with ovarian cancer. Each had participated in a supportive care group process Soul-Medicine prior to volunteering. Three women, Beth, Carrie, and Denise contributed to this study. The methodology was grounded in Gaston Bachelard’s philosophy of poetic-phenomenology. Data was analyzed with attention to image-centred knowledge; material imagination; reverie; and horizons of hope to elucidate their implicated aspects of wisdom and the ways participant’s formed their personal wisdom integrating feminist theories of embodiment and bioethics.

Findings are framed through three images of a uniquely formed inner ‘wisdom-compass’, an …

Exploring Harm Reduction Among Canadian Veterans Experiencing Homelessness, Olivia Marsella

Electronic Thesis and Dissertation Repository

BACKGROUND: The use of substances is substantially higher among people experiencing homelessness than the general population (Podymow, Turnbull, Coyle, Yetisir, & Wells, 2006). In Canada, veteran homelessness is an increasing concern and it is estimated that there are 2,950 veterans experiencing homelessness (Gaetz et al., 2016). Furthermore, veterans often use substances, particularly alcohol, to cope with the transition from the military to civilian life (Ray & Forchuk, 2011). A strategy that has been shown to reduce the negative harms of substance use and facilitate housing stability is harm reduction (MacNeil & Pauly, 2010). Exploring how veterans who have experienced homelessness …

Recommended Interventions To Address The Education-Practice Gap In Mental Health Nursing: An Integrated Literature Review, Marlena D'Agostin

Grace Peterson Nursing Research Colloquium

Abstract

Background: Mental health is all encompassing and is widely prevalent in the U.S. population, demonstrating a need for effective care for patients in the mental health setting. There is a gap, however, in providing the highest quality of care within this setting named the theory-practice gap. The theory-practice gap creates a barrier in translating knowledge that is being taught in the classroom to what is used in clinical practice.

Objectives: The purpose of this integrative literature review was to investigate the theory-practice gap in mental health nursing through the implementation of evidence-based practice (EBP) in the clinical practice setting …

Barriers To Providing Psychiatric Care Within Cook County Public Health System: An Integrative Literature Review, Elizabeth Ann Reuter

Grace Peterson Nursing Research Colloquium

Abstract

Background: Cook County Public Health Systems located in Cook County, Illinois, are responsible for providing free and low cost psychiatric care to thousands of residents despite continuing state and federal budget cuts and inadequate Medicaid reimbursements. This not only financially strains county taxpayers, but it also limits treatment options, negatively impacts patients, and places an extreme burden on the public service workforce.

Objectives: The purpose of this integrative literature review was to identify the major barriers of providing psychiatric care within Cook County Public Health Systems.

Method: An integrative literature review was conductedusing the databases of Academic Search …

Common Components Of Fetal Alcohol Spectrum Disorder Prevention Intervention Programs: A Review Of Literature, Ross Siemering

Grace Peterson Nursing Research Colloquium

Abstract

Background: Fetal alcohol spectrum disorders (FASD) are the most common yet completely preventable cause of mental disability in the western world.

Objective: The purpose of this integrative literature review is to examine and identify the common elements among varying interventions for FASD prevention that have demonstrated effectiveness for reducing the risk of FASD to better understand what defining features may contribute to the efficacy of the interventions.

Methods: An integrative literature review was conducted. The databases searched included: CINAHL, PubMed, Cochrane Library, and Science Direct. Articles were then reviewed to determine if they were appropriate for inclusion based upon …

Nurses Role In Health Home Mixed Methods Study, Jacqueline S. Prokop

Nursing Theses and Dissertations

Managing individuals with chronic health conditions in the primary care setting continues to be a significant challenge in the U.S. health care system. This issue is further compounded for low-income individuals with both mental health and physical health chronic conditions. With the enactment of the Affordable Care Act (ACA), new chronic disease health home opportunities have emerged to address the existing structural and process gaps found in primary healthcare. The nurse’s role is integral to health homes as they empower nurses to play a greater role in improving patient experiences, population health, and lowering healthcare costs. Three research manuscripts presented …

Failure-To-Rescue Simulations As A Risk Management Strategy For Registered Nurses, Trena K. Seago

Graduate Theses, Dissertations, and Capstones

In the hospital setting, prevention of failure-to-rescue (FTR) events is an important aspect of patient safety. The use of patient simulation as a strategy to educate nurses on the prevention of these events offers two modes of learning: 1) experiential learning through simulation and 2) reflection through debriefing. The act of practicing to recognize a deteriorating patient through experiential learning and reflection may help increase nurses’ self-efficacy in recognizing a similar situation in their future practice. This quasi-experimental, one-group, pretest-posttest pilot study investigated the use of patient simulation among registered nurses (RNs) in the hospital setting as an anticipatory educational …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Care For Inmates With Mental Illness: What Can Nurses Do?, Rebecca K. Sakai

Honors Projects

This paper serves to inform nurses of the medical and psychiatric treatment that inmates with mental illness receive and to offer suggestions for treatment interventions. Current practice includes mental health screens, psychotropic medication administration, psychiatric departments, and administrative segregation. The recommended interventions include providing therapy (including Cognitive Behavioral Therapy and Group Therapy), decreasing administrative segregation, implementing reintegration programs, and training and collaborating with correctional officers.

A Common Goal: Primary Care And Psychiatry Improve Depression Detection And Outcomes, Katherine Kilkenny

Doctor of Nursing Practice Final Manuscripts

Background: Major Depressive Disorder (MDD) affects over 15 million (6.7%) adult Americans. While one in four primary care patients suffer from depressive symptoms, MDD is accurately diagnosed as little as 25% of the time.

Purpose: Implementation of an evidence-based protocol outlining the process for screening, behavioral health referral, and the role of a collaborative care team would improve detection and treatment of adult MDD patients in the ambulatory setting.

Process: A systematic Patient Health Questionnaire (PHQ-9) based screening protocol was implemented. Every new and existing patient completed the PHQ-9 during scheduled primary care appointments. If a patient scored 15 or …

Family Nurse Practitioner Student Competencies In Integrated Psychiatric Healthcare, Mark Manning

Doctor of Nursing Practice Final Manuscripts

Title: Practicum to Practice: Family Nurse Practitioner Student Competencies in Integrated Psychiatric Mental Healthcare.

Background: Major Depressive Disorder (MDD) is a widespread and costly diagnosis that affects nearly 16 million people annually and costs the United States nearly $83 Billion. Primary care providers such as Family Nurse Practitioners (FNP) play a crucial role in screening for health problems, preventing, and managing illness. Opportunities exist to integrate psychiatric mental healthcare into FNP curriculum and clinical practicums to better prepare providers to identify and screen for depression.

Purpose: The purpose of this evidenced-based practice project is to evaluate FNP student competencies …

Metabolic Syndrome Screening Among Inpatient Psychiatric Patients, Susan Magorno

Doctor of Nursing Practice Final Manuscripts

Background: More than 50% of patients with severe mental illness carry undiagnosed Metabolic Syndrome (MetS) comorbidities of hypertension, hyperlipidemia, or diabetes. These patients are three times more likely to die of cardiovascular-related causes; however, this population is not routinely assessed for MetS and frequently lack appropriate treatment.

Objective: The objective is to implement a screening tool designed to identify risk for MetS and trigger appropriate treatment.

Design: The screening tool triggers the provider to address positive criteria through interventions such as further evaluation, medical and/or diabetes educator consultation.

Results: Although overall rates of screening improved significantly, follow-up interventions were …

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 …

Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller

Master's Theses

This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …

Nature's Effect On Mental Health, Hannah Thomas

Senior Honors Projects, 2010-2019

The United States has an overwhelming number of people suffering from mental illness, especially anxiety and depression. These disorders can be debilitating in many areas of the person’s life. Not even half of those diagnosed with these conditions are treated effectively and costs are expected to rise significantly in the coming years. One population that is often overlooked that suffers from these conditions is health professionals themselves. Physicians and nurses have high rates of depression and anxiety due to the stress from their occupation. In order for more patients and providers to be treated and for the health care system …

Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott

DNP Scholarly Projects

The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …

Pornography As A Public Health Issue: Promoting Violence And Exploitation Of Children, Youth, And Adults, Elisabeth Taylor

Dignity: A Journal of Analysis of Exploitation and Violence

The pornography industry is expanding exponentially as a result of ongoing technological advances. The ability to stream videos over the internet and the ubiquity of the smart phone have meant that pornography producers are able to use algorithms to target potential consumers, to cultivate new sexual tastes and to deliver content to a more diverse audience over mobile devices. The advent of virtual reality pornography with interactive sex toys and sex robots imbued with artificial intelligence promises to unleash a further step-change in the extent to which pornography influences ‘real-world’ sexual culture. The critical analysis of pornography undertaken over decades …

Elementary School Teachers' Student Health Concerns And Knowledge Of Resources, Aubrey Gahagan

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Teachers are with their students an average of seven to 10 hours a day, five days a week. The substantial amount of time teachers spend with their students allows them to provide helpful insight into health problems children face. The purpose of this study was to identify elementary school teachers’ concerns for student health and to assess their knowledge of resources that address those health concerns. A convenient sample of 86 teachers from three elementary schools in Northwest Arkansas was surveyed. Surveys were used to identify the three main concerns teachers have for their students. A cross-sectional design was used …

School Nurses' Knowledge And Perceived Role In Mental Health Issues, Kayla Bakker

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background:

There are 74.5 million children in the United States, 17.1 million currently or have previously dealt with a mental disorder (Children’s Mental Health, 2015). Unfortunately, the negative stigma associated with mental health often causes those affected to not seek treatment. School nurses are on the front line of public health problems and deliver safe, effective evidence-based practice to their communities. To rebuild our broken mental health system, community nurses need to build upon school mental health services and encourage more in-school programs (Stephan, Weist, Kataoka, Adelsheim, & Mills, 2007). School nurses must be included in the discussion when …

Attitudes Of Middle School Children Towards Mental Health Programs, Catherine Taylor

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Despite years of school mental health services, today’s youth remain in need of mental health resources. While schools provide a variety of services to help reduce mental health disparities, there is limited information concerning the success of services offered. The purpose of this study was to examine the attitudes of middle school children towards mental health programs offered at the selected study site. The design utilized was a cross sectional design using a convenience sample of middle school children in Northwest Arkansas. The results indicated that middle school children need a unique variety of programs offered to support their …