Psychiatric and Mental Health Nursing Commons^™

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

Bi-Weekly Follow-Up Of Adult Patients Diagnosed With Schizophrenia To Increase Treatment Adherence: A Scoping Review, Garrett L. Seaton, Bsn, Rn, Michelle A. Conteh, Bsn, Rn, Shelia L. Jackson, Msn, Bsn, Rn, Sharon H. Little, Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a complex psychiatric disorder that can significantly affect a patient’s psychological state. Because of this, medication nonadherence is reported as one of the most common causes of relapse and rehospitalization in patients diagnosed with schizophrenia. Although long-acting injectable (LAI) antipsychotics can help provide more continuous treatment, they do not address other factors that affect treatment adherence. This scoping review will evaluate existing literature to assess if a multimodal approach, such as increased patient follow-ups in addition to scheduled, current-practice LAI treatment and management, may increase treatment adherence in adult patients diagnosed with schizophrenia.

Methods

A database search …

Mental Health Navigators Bridging The Gap Of Care For Clients With Schizophrenia: A Review, Valentina Loreto-Ashley, Valentina Loreto-Ashley

DNP Qualifying Manuscripts

Background: Schizophrenia is a thought disorder. As such it affects an individual level of function, and often leads to acute hospitalization. When clients with schizophrenia disorders are discharged, they are a great risk for suicide and danger to others. Services aimed at bridging patients from an acute facility to their community setting could be essential in helping the client in treatment to reach functional recovery and avoid relapse.

Objective: This article explores the role of mental health peer navigators in improving treatment adherence for adult clients with schizophrenia spectrum disorder being discharged from a psychiatric facility into their unique community …

Smoking Addiction In Patients With Schizophrenia Spectrum Disorders And Its Perception And Intervention In Healthcare Personnel Assigned To Psycho-Rehabilitation Programs: A Qualitative Research, Pasquale Caponnetto, Marilena Maglia, Marta Mangione, Chiara Vergopia, Graziella Chiara Prezzavento, Riccardo Polosa, Maria Catena Quattropani, Jennifer Dipiazza, Maria Salvina Signorelli

Publications and Research

Patients with schizophrenia spectrum disorders have a higher prevalence and frequency of smoking rates when compared to the rest of the population; to this, it must be added that they develop a greater dependence and have some worse health consequences than the general population. This is qualitative research on the perception of smoking in healthcare professionals assigned to psycho-rehabilitation programs for patients with schizophrenia spectrum disorders. The point of view of health personnel (Psychologists, Psychiatrists, Pedagogists, and Nurses) about cigarette smoking in these patients was analyzed, focusing on their implications in disturbance and comparing them with e-cigarettes too. The methodology …

Education To Improve Long-Acting Injectable Antipsychotic Use, Travis Donald Wolfangel

Dissertations

Purpose: Long-acting injectable (LAI) antipsychotics are underutilized as an evidence-based treatment for schizophrenia and schizoaffective disorder. The purpose of this quality improvement project was to determine if a web-based LAI education module changed advance practice prescribers’ knowledge, attitudes, and practice behaviors regarding LAI antipsychotics one month after receiving LAI education at a community-based mental health organization.

Methods: This QI project was an observational pre- post-educational design. The 20-item Knowledge, Attitudes, and Practices (KAP) questionnaire was used to assess advanced practice providers’ knowledge retention, attitude changes, and practice modifications regarding LAI antipsychotics and prospective patient chart reviews were performed. …

Advancing The Care Continuum For The Homeless: A Shelter-Based Care Coordination Project Focused On Mental Health, Alexandra H. Sain, Allyson Neal Dr, Deborah Nichols Mrs.

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Advances in the care continuum are crucial for those with serious mental illness, especially those homeless individuals in the community. Schizophrenia is a leading cause of re-hospitalization and disability, accounting for billions of dollars spent in the United States. A prominent city shelter reports the prevalence of schizophrenia among its guests, and the community recognizes homeless shelters as the greatest source of 911 calls with countless surrounding emergency department visits. This project’s purpose is to implement a shelter-based, internal process to identify these high-risk guests and increase their subsequent care coordination services. Outcomes reflect individual benefits with increased shelter-based contacts …

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 …

Implementation Of A Protocol To Improve Quality And Use Of Existing Crisis Safety Plan, Kaitlynn Earls

Epsilon Sigma at-Large Research Conference

Implementation of a Protocol to Improve Quality and Use of Existing Crisis Safety Plan

Kaitlynn Earls, Dr. Jo-Ann Marrs, Dr. Judy Rice, Dr. Beth Schreiner. College of Nursing, East Tennessee State University.

Crisis safety plans are an important tool for decreasing suicide attempts if a crisis situation arises. Pre-implementation data found that only approximately 20% of clients with schizophrenia/schizoaffective disorder in medication services only had a up to date crisis safety plan in place.

The purpose of this quality improvement project is to implement and evaluate a protocol to increase the use of an already established crisis safety plan in …

Pineal Gland Abnormalities And The Relationship Of Melatonin To The Development And Symptom Severity Of Schizophrenia: An Integrative Review Of The Literature, Kathryn Margretta

Honors Undergraduate Theses

The purpose of this thesis is to critique the literature focusing on the role of pineal gland volume and function and the development of schizophrenia by asking the question, "What is the relationship between pineal gland physiologic function and development and symptom severity of schizophrenia? It is crucial that health care providers continue advocate for better understanding of schizophrenia in order to develop a more appropriate treatment and relive the suffering of those with schizophrenia. A review of published literature focusing on the pineal glands association with schizophrenia was performed using several databases including: ScienceDirect, PubMED, Google Scholar, Cumulated Index …

Ontrack: A Program Evaluation, Justin Mynatt

Doctoral Projects

OnTrack is a program that provides coordinated specialty care (CSC) services for patients who have experienced their first episode of psychosis (FEP). Appropriately identifying and aggressively treating this vulnerable population, while providing support to both them and their families is critical for improved outcomes. Appropriate treatment of FEP patients can improve their quality of life, preserve brain matter, improve overall functioning, and lessen the burden of the clients’ family who may be involved in their care, such as caregiver strain or financial hardship. The purpose of this project is to evaluate the success of OnTrack, a FEP program, at improving …

Do Not Miss Your Shot: Improving Follow-Up In Patients Receiving Long-Acting Injectable Medications, Mary O'Hara

Doctor of Nursing Practice Final Manuscripts

Background: Serious mental illness including schizophrenia and bipolar disorder affects 1 in 24 adults in California. These chronic disorders are difficult to treat and often sabotaged by medication nonadherence. Long-acting injectable (LAI) medications are one strategy to combat medication nonadherence. Effectively providing treatment with LAI medications can be challenging at the clinic level.

Objectives: Reduce the number of days without medication by reducing the number of days between injection due date and injection administration for patients receiving LAI medications.

Design: Establish appointments for all injection visits. Standardize visit protocol for injection encounters to optimize provider time. Arrange immediate follow-up and …

The Impact Of Schizophrenia On Copd Readmission Rate Among Hospitalized South Carolinians, Emilienne Y. Watonsi

DNP Research Projects

Due to elevated readmission costs, the Affordable Care Act established the Hospital Readmission Reduction Program in 2012 to curb the 30-day readmission rates. COPD and schizophrenia are two very expensive diseases, COPD national medical costs is projected to be $49.0 billion in 2020; the cost of schizophrenia was 155.7 billion in 2013. The main objective of this study was to determine if schizophrenia is a significant predictor of 30-day readmission following hospitalization for acute exacerbation of COPD after adjusting for age, gender, anxiety, smoking status, T2DM, chronic ischemic heart disease, and GERD. Methods: A retrospective cohort design was used to …

Korean Sibling Caregivers Of Individuals Diagnosed With Schizophrenia, Mijung Park, Kwang-Ja Lee

Asian/Pacific Island Nursing Journal

Siblings of individuals diagnosed with schizophrenia are an important source of family caregiving. Unfortunately, limited information is available about sibling caregivers because existing studies have focused on other family relationships such as parents, spouses, and children. To fill the knowledge gap, the purpose of this study is to describe Korean sibling caregivers’ experience with individuals diagnosed with schizophrenia.

Guided by Colaizzi’s descriptive phenomenological methodology, we conducted in-depth, semi-structured, face-to-face interviews with eight individuals who have a sibling (1) diagnosed with schizophrenia and (2) hospitalized in an inpatient psychiatric unit. We discerned six key themes: sorrow, burnout, shame, different perspectives in …

Continuing Professional Development Program On Second-Generation Antipsychotics For Psychiatric-Mental Health Staff Nurses, Brenda Lee Phillips

Doctoral Projects

The lack of continuous professional development education regarding second-generation antipsychotics (SGAs) at a regional state acute care psychiatric hospital limits the ability of psychiatric-mental health (PMH) staff nurses to provide care for patients with or at risk for metabolic syndrome and other medical problems. The goals of the evidence-based program were to (1) examine PMH staff nurses’ knowledge of treatment guidelines for schizophrenia and SGAs; (2) provide education on schizophrenia, SGAs, and metabolic syndrome; and (3) provide continuous professional development training modules on schizophrenia and SGAs electronically for PMH staff nurses in an acute care mental health hospital. The effectiveness …

Motivating Persons With Schizophrenia To Exercise: Rationale And Design, Lora Humphrey Beebe Phd, P Mhnp-Bc, Renee Burk, Kelly B. Mcintyre, Kathlene Smith, Dawn Velligan, Barbara Resnick, Abbas Tavakoli, Cliff Tennison, Olivera Dessieux

Faculty Publications and Other Works -- Nursing

Persons with schizophrenia spectrum disorders (SSDs) are not only at risk because of disabling disease symptoms but because necessary medications create health risks associated with high rates of obesity. Despite the well-known benefits of exercise, persons with SSDs rarely adhere to such regimens; few interventions to motivate exercise behavior have been tested in this group.

The purpose of this study is to examine effects of the Walk, Address sensations, Learn about exercise, Cue exercise behavior for persons with SSDs (WALC-S) motivational intervention upon exercise behavior. We will recruit a total of eighty outpatients 18–68 years, meeting these criteria: 1) chart …

Motivating Persons With Schizophrenia To Exercise: Rationale And Design, Lora Humphrey Beebe Phd, P Mhnp-Bc, Renee Burk, Kelly B. Mcintyre, Kathlene Smith, Dawn Velligan, Barbara Resnick, Abbas Tavakoli, Cliff Tennison, Olivera Dessieux

Lora Humphrey Beebe PhD, PMHNP-BC

Persons with schizophrenia spectrum disorders (SSDs) are not only at risk because of disabling disease symptoms but because necessary medications create health risks associated with high rates of obesity. Despite the well-known benefits of exercise, persons with SSDs rarely adhere to such regimens; few interventions to motivate exercise behavior have been tested in this group.

The purpose of this study is to examine effects of the Walk, Address sensations, Learn about exercise, Cue exercise behavior for persons with SSDs (WALC-S) motivational intervention upon exercise behavior. We will recruit a total of eighty outpatients 18–68 years, meeting these criteria: 1) chart …

A Revision Of The World Health Organisation Psychiatric Disability Assessment Schedule, Daniel Rock

Theses: Doctorates and Masters

The burden schizophrenia places on the individual, on the family and on society in general is determined more by the associated disability rather than the manifest symptoms. Therefore, measurement of disability provides a baseline for evaluating change and directing treatment. This research has two main aims. The primary purpose of this study was to develop and validate a contemporary revision of the World Health Organisation-Psychiatric Disability Assessment Schedule (1988). Data used was based on data from the WHO Collaborative Study on Determinants of Outcome of Severe Mental Disorders (Sartorius et al., 1986). The second aim of this study was to …