Compassion Fatigue And Burnout In Community-Based Psychiatric Staff, Faith Carini-Graves

Advances in Clinical Medical Research and Healthcare Delivery

Community-based psychiatric staff, such as the Youth ACT teams that are being initiated across New York State, are at risk for compassion fatigue due to their proximity to the trauma of their patients. This literature review explores current evidence that is available on the topic and grapples with what can be done to support psychiatric staff who work in the community with patients who experience trauma.

Implementing A Standardized Ssri Tapering Protocol In The Outpatient Setting, Chelsea Sopo-Ngwa

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Selective serotonin reuptake inhibitors (SSRIs) are one of the most prescribed antidepressant medications in the outpatient psychiatric setting. Abrupt discontinuation or improper tapering of these medications may result in SSRI withdrawal symptoms. Adverse effects may lead to poor patient outcomes and increase healthcare utilization. A baseline chart review and provider readiness survey within the outpatient psychiatric practice revealed inconsistency in provider documentation related to SSRI tapering plans, patient education, and follow-up planning. The gap in practice highlighted the lack of a standardized SSRI tapering protocol to guide evidence-based medication tapering practices and promote patient safety.

Aim: The …

Optimizing Psychiatric Care Through Pharmacogenomics: An Evidence-Based Program To Increase Multi-Gene Pharmacogenomic Testing And Provider Competence In Mental Health Settings, Marc Boulanger

Doctor of Nursing Practice Final Manuscripts

Objective: This scholarly project aimed to enhance psychiatric providers' competency, confidence, and knowledge in the PHASER pharmacogenomic (PGx) testing program at the VA San Diego Healthcare System.

Background: PGx testing enhances psychiatric care by enabling precise medication management tailored to a patient’s genetic profile, improving treatment effectiveness and reducing adverse drug reactions. Despite demonstrated clinical utility, adoption of PGx remains limited due to provider knowledge gaps. This project addresses these gaps through targeted education.

Methods: Two educational modules, developed with input from the PHASER site-lead, aimed to enhance provider knowledge and confidence in PGx. Module one introduced the PHASER program …

Implementing Lean Methodology To Decrease Wait Times In A Psychiatric Emergency Department, Kristina S. Baxter

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project aimed to implement Lean strategies to optimize the intake process in a psychiatric emergency department, thereby reducing patient wait times, minimizing left-without-being-seen (LWBS) occurrences, and improving access to timely psychiatric care.

Background

The project was conducted in a hospital-based psychiatric emergency department in Southeast Texas, serving adults and children six years and older.

Methodology

Lean methodology and PDSA cycles were employed to refine the intake process and eliminate inefficiencies. Key interventions included patient transport by technicians to minimize delays, using tele-clinicians for assessments to reduce staff burden, and restructuring nursing assessments to prioritize telehealth consultations …

Electronic-Based Determinants Of Health Screening On An Inpatient Behavioral Health Unit, Anyaku O. Okpara

Dissertations

Problem: Approximately 14.1 million Americans are diagnosed with a Serious Mental Illness (SMI). These individuals experience death 10-20 years earlier compared to the general population, primarily due to chronic medical comorbidities and unmet health-related social needs (HRSNs). Mortality rates, increased healthcare utilization, and frequent readmissions in patients with multiple, unmet HRSNs are likely to remain high unless developments such as the incorporation of standardized, multi-domain, social determinants of health (SDOH) screenings into electronic health records (EHRs). The purpose of this quality improvement (QI) project, guided by the Institute for Healthcare (IHI) model for change utilizing the Plan-Do-Study-Act (PDSA) cycle, was …

The Impact Of Structured Weekend Group Therapy On Restraints, Seclusion And Length Of Stay On Inpatient Psychiatric Units, Victoria Grau

West Chester University Doctoral Projects

Group therapy is an essential part of inpatient psychiatric treatment, with documented positive effects including better medication compliance, lower readmission rate, and improved self- esteem. Patients who are admitted for an inpatient psychiatric stay have a small window of time in which behavioral health staff can work with them. Group therapy can help patients develop a plan for these issues and provide a foundation for successful discharge and symptom management. The project site is a mid-size teaching hospital in an urban community with higher rates of mental health diagnoses than the national average. Group therapy was conducted initially Monday – …

Implementation Of Controlled Substance Agreements In An Adult Outpatient Psychiatric Clinic, Bryana Weimer

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice (EBP) Doctor of Nursing Practice (DNP) project was to evaluate the clinical applicability of Controlled Substance Agreements (CSAs) in the adult outpatient psychiatric clinical setting. The first goal was to determine the frequency of Controlled Substance Agreement (CSA) utilization. The second goal was to identify potential outcomes associated with the implementation of CSAs, such as improved monitoring practices. Finally, this project aimed to evaluate provider perception of the efficacy of CSAs.
Background: The misuse and diversion of prescribed controlled substances contribute significantly to addiction and fatalities nationwide. Prescription psychotropics are the second most …

Implementation Of A Peer Mentoring-Network Initiative In Outpatient Psychiatry To Improve Psychiatric Advanced Practice Nurses' Job Satisfaction, Maria Romanoff Rand

Doctor of Nursing Practice Scholarly Projects

Background: Post-pandemic rates of mental illness have increased, resulting in a rise in demand for psychiatric services. At the same time, a growing shortage of psychiatric providers is occurring. This combination has given rise to an expanding mental health crisis where strengthening and stabilizing the psychiatric workforce is paramount. Psychiatric Advanced Practice Nurses are uniquely qualified to staff this shortage. Therefore, positive job satisfaction for Psychiatric Advanced Practice Nurses is vital to increase and retain psychiatric healthcare providers available to address this critical need for mental health services.

Methods: At the project site, the shift to telehealth, changing leadership, and …

Implementation Of Nurse Navigators For Behavioral Health, Theresa Papagna

Seton Hall University Dissertations and Theses (ETDs)

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

Minimizing Workplace Violence By Initiating An Evidence-Based Community Meeting, Olivia Gabrielle Foster

Dissertations

Problem: Workplace violence (WPV) in healthcare has become an epidemic demanding change. WPV is three to four times higher in the healthcare industry compared to other workplaces. For this project, WPV will be defined as any act of physical violence from a patient to a staff member. Community meetings are one evidence-based approach to decreasing WPV in psychiatric inpatient hospitals. Methods: This descriptive observational project compared data before and after implementing a targeted WPV community meeting, including unit rules, staff and patient expectations, a definition of WPV, and medication options available to reduce anxiety and irritability. This project …

Balancing Provider Stress And Resilience In The Time Of Covid, Zachary Love

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice project is to improve secondary traumatic stress (STS), compassion satisfaction, and burnout amongst providers—physicians, residents, and nurse practitioners—within the acute psychiatry units of the La Jolla Veterans Health Administration (VHA) through a one-time educational training session.

Background: Mental health providers at the VHA acute psychiatry units experience one of the highest risks for the development of STS, CF, and burnout amongst all professions due to a number of individual and institutional factors. STS is characterized by secondhand traumatization with symptoms similar to that of Post-Traumatic Stress Disorder—difficulty sleeping, mood changes, upsetting images appearing …

Addressing Medical Mistrust In In-Patient Psychiatric African American (Aa) Patients, Eselle Molua

DNP Scholarly Projects

Abstract

Background: Medical Mistrust (MM) is associated with patient dissatisfaction, treatment nonadherence, and poor health outcomes. In the United States, MM is prevalent in African American patients in In-Patient Psychiatric settings. Caregiver training and education on MM and cultural sensitivity can help identify mistrust and provide strategies to increase trust and reduce mistrust.

Purpose: The aim of this project was to implement an educational tool to improve caregiver awareness about knowledge of MM. By doing so, it was the goal to enhance cultural sensitivity skills and patient-centeredness in the African American population at the adult psychiatric unit in Northwest …

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 …

Falls Program On An Acute Psychiatric Unit, Joseph Hunter Rose

Master's Projects and Capstones

In the metropolitan hospital’s acute psychiatric unit there has been an increase in falls incidence as well as need for evaluation of the effectiveness of Schmid Fall Risk Assessment tool in its ability to properly identify those at risk. In the last fiscal year there were 45 falls among 28 patients on the acute psychiatric unit.Falls are harmful to the patients and can cause prolonged hospital stays with non-reimbursable costs to the hospital. Falls amongst psychiatric patients is an even greater challenge to address due to the nature of the mental health disease process. This project addresses general costs of …