Psychiatric and Mental Health Nursing Commons^™

Implementation Of A Daily Engagement System Board (Desb) To Improve Hospital Staff Communication, Catherine Villanueva

Master's Projects and Capstones

Implementation of a Quality Improvement (QI) project to help improve staff communication between shifts at an Inpatient Acute Psychiatric Unit was determined to be of immense need. This unit is part of a large acute medical hospital. Currently, the end of shift report consists of a verbal report along with a robust printed end of shift report consisting of shift related information. This printed end of shift report can have as many as seven to nine pages thus causing information overload and decreases prioritized patient information. Furthermore, missed information or too much information can be provided in the verbal shift …

Developing A Trauma-Informed Family-Centered Care Toolkit For Neonatal Intensive Care Unit Nurses, Sonja A. Alli-Casella

DNP Qualifying Manuscripts

Background: The neonatal intensive care unit (NICU) may be a stressful, traumatizing, or re-traumatizing experience for parents of critically ill newborns and infants.

Problem: NICU nurses and other healthcare providers may not realize their impact on parental stress responses as neonatal care providers may not have adequate training to support adults experiencing acute emotional distress.

Methods: Strong evidence supports using family-centered care (FCC) in the NICU to promote bonding and parental involvement in caring for their infants. This manuscript aims to review current research and literature on trauma-informed care training and its impact on nurse confidence in managing dysregulated adults, …

Empowering Staff Through Trauma-Informed Care: A Quality Improvement Initiative For Enhancing Patient Satisfaction And Care Delivery, Ijezie G. Anozie

Doctor of Nursing Practice Final Project Abstract

The quality improvement project aimed to implement a Trauma-Informed Care (TIC) care delivery model to increase patient satisfaction with their hospital experience. Increasing patient satisfaction was measured by the Net Promoter Score (NPS), and improvement would be evidenced by an increase of 40% (NPS) within four months of the implementation of trauma-informed care (TIC) principles in the inpatient psychiatric facility. The NPS served as a proxy measure for the successful implementation of this quality improvement project. The intervention integrated TIC training through the HealthStream platform, a skills fair, interactive sessions, a guidebook, and continuous data monitoring. Weekly meetings, educational materials, …

Effectiveness Of Mental Health Interventions For Adults With Cancer In The Us: An Integrative Review, Danielle Lee, Chelsea Ferguson

Master's Projects

The purpose of this review was to synthesize existing literature on the effects of mental health interventions for adult cancer patients following their initial diagnosis and to consolidate findings related to interventions addressing mental health conditions in this population. With the growing number of adults diagnosed with cancer, further research and the development of tailored mental health interventions are crucial to improving health outcomes.

A systematic search was conducted using PubMed, CINAHL, Medline Complete, and Health Source Nursing databases between January 2024 and February 2024. To ensure rigor, Toronto and Remington’s (2020) integrative review process was applied. The Johns Hopkins …

The Implementation Of Ketamine-Assisted-Psychotherapy On Healthcare Workers Suffering From Workplace-Related Ptsd Due To Covid-19, Ziluolan Zou

Nursing | Student Research Posters

During the coronavirus disease 2019 (COVID-19) pandemic, healthcare workers were exposed to a deadly disease with limited knowledge and personal protective equipment, subjected to long hours, forced to ration care due to limited critical care resources and ventilators, and isolated from their families due to fear of spreading the virus. These factors further compounded the occupational stress associated with being a healthcare worker. The literature shows that the physical, mental, and emotional challenges frontline healthcare workers faced during the COVID-19 pandemic had lasting impacts on their mental health. The prevalence of mental health illnesses, such as post-traumatic stress disorder, among …

Early Referral For Eye Movement Desensitization And Reprocessing Therapy For Treatment Of Trauma-Induced Anxiety And Emotional Distress, Christa Jones

Doctoral Projects

Trauma, anxiety, and emotional distress are significant health concerns affecting millions globally and resulting in significant healthcare burdens. Despite the considerable efforts in addressing problems, most high-risk cases often go unidentified or unaddressed promptly. Besides standard trauma diagnosis, treatment, and management protocols, some patients often require specialized support. Recently, Eye Movement Desensitization and Reprocessing (EMDR) has emerged as a promising alternative for treating anxiety, trauma, and emotional distress conditions, yet many patients who are at high risk are often not identified early for referral. Additionally, many healthcare facilities, especially those in rural settings, fail to include appropriate screening tools.

This …

Investigating The Effects Of Workload Management Strategies On Nurse Practitioner Burnout And Job Satisfaction, Erica G. Smith

Doctoral Projects

Burnout is a critical issue among psychiatric mental health nurse practitioners (PMHNPs), worsened by excessive workloads, productivity demands, and the emotional intensity of patient care (Chi et al., 2024). The negative effects of burnout included diminished job satisfaction, reduced quality of care, and increased turnover (Chi et al., 2024). As the demand for Psychiatric Mental Health Nurse Practitioners (PMHNPs) grew, addressing these challenges was essential for maintaining a sustainable workforce and ensuring quality patient care.

This doctoral project aimed to assess the impact of a workload management strategy on reducing burnout and improving job satisfaction among PMHNPs in a hospital …

Improving Outcomes Of Patients Being Seen In The Emergency Room For Mental Health Crisis, Kimberly Hudson

Doctoral Projects

Mental health is a significant problem, especially in males aged 20 to 50 years old (Omary, 2019). Lack of a primary mental health care provider, lack of proper treatment and follow up appointments for this population, and bottlenecking patients in the emergency room are all factors that contribute to the problem. As a result, these patients experience negative outcomes such as not receiving proper care and/or causing harm to themselves or others. In this doctoral project we will explore the option of patients having better outcomes if seen immediately by a psychiatric health care provider.

Having psychiatric healthcare providers in …

Incorporating The Pcl-5 Self Assessment Tool In The Treatment Of Post Traumatic Stress Disorder Using Virtual Reality Therapy, Janette Sanchez

Doctor of Nursing Practice

Background. Post-traumatic stress disorder occurs when individuals experience a traumatic event causing symptoms of depression, anxiety, and cognitive difficulties (Sadock et al., 2017). Failure to assess changes in post-traumatic stress disorder symptoms can result in ineffective treatments (Department of Veterans Affairs & Department of Defense, 2023). Purpose. Implement the Post Traumatic Stress Disorder Checklist for DSM-5 screening tool as part of an outpatient clinic’s virtual reality exposure therapy protocol evaluating patients’ perceived effectiveness of virtual reality exposure therapy in post-traumatic stress disorder management. Methods. All staff and providers were educated on the use of the PCL-5 screening tool. Patients were …

Enhancing Warning Signs Of Mental Health Literacy: Evaluating A Digital Base Intervention For Health Profession Students, Nashwa Ibrahim

Nursing

Background: Despite its importance, Mental health literacy (MHL) among nursing and other health profession students often remains inadequate, potentially impacting their future roles as healthcare providers. This inadequacy can lead to delayed or inappropriate care for individuals with mental health concerns, perpetuating adverse outcomes and increasing the burden on healthcare systems. Aim: To evaluate a digital-based intervention designed to enhance the warning signs of mental health literacy among health profession students. Design: A quasi-experimental, one-group pretest-posttest study design was used to conduct the current study. Methods: A non-randomized trial was conducted using digital mental health literacy intervention about the warning …

Domestic Violence And Mental Health In Pregnant Women, Arabella M. Co

Nursing | Student Research Posters

Background: Domestic violence can include verbal, emotional, and physical abuse, which can lead to long-term mental health disorders such as stress, anxiety, or post-traumatic stress disorder. Purpose: This research includes a literature review, as well as a proposed research design to examine the significance of intimate partner violence in relation to mental health by implementing screening methods and interventions. Method: Participants will be recruited from prenatal clinics around the Bay Area. A quantitative, randomized, controlled-trial cohort study will investigate the effectiveness of the Pregnancy Risk Assessment Monitoring Systems (PRAMS). A screening tool used in determining intimate partner violence within the …

Improving Consistency Of Quality-Of-Life-Assessments In Schizophrenia Patients Through Structured Education For Healthcare Providers, Dorothy Stewart

Doctoral Projects

Schizophrenia is a chronic and debilitating mental disorder that significantly impacts patients' quality of life (QoL). Effective management of schizophrenia requires not only symptom control but also a comprehensive assessment of QoL to guide treatment plans. The Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) is a specialized tool designed to evaluate the unique challenges faced by patients with schizophrenia. However, inconsistencies in the administration and interpretation of the SQLS-R4 by healthcare providers have led to variability in patient care. This doctoral project aimed to address this gap by implementing a structured educational intervention for healthcare providers that focused on …

Optimizing Laboratory Appointment Adherence Among Patients Prescribed Psychoactive Medications, Tamara N. Blake

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of this scholarly project was to implement a standardized nurse-driven phone call reminder protocol to improve adherence to scheduled laboratory appointments among patients prescribed psychoactive medications requiring bloodwork. This protocol is aimed to increase appointment adherence and reduce no-show rates within the clinic.

BACKGROUND

The project was implemented within a small outpatient community-based clinic in Round Rock, Texas which provides mental health services. The clinic experienced high no-show rates for scheduled laboratory appointments among patients prescribed psychoactive medications. Monitoring these patients is essential to ensure medication safety and prevent potential adverse effects.

METHODOLOGY

The six-week quality improvement …

Munchausen Syndrome By Proxy Presentation, Giovanna Tomassoni, Meredith Mackenzie

Master's Projects

Munchausen syndrome by proxy (MSBP) is a serious form of child abuse in which the perpetrator is typically the victim’s maternal caregiver. Assessing for MSBP can be very challenging for medical providers due to symptom mimicry and a dearth of information about the disorder. This Integrative Review seeks to shine a light on common symptomatology of MSBP and to make sure that providers leave it on the differential diagnosis until alternative diagnoses can effectively exclude it. A total of 240 records from online databases were reviewing for content, currency, and rigor. This search was narrowed to 10 records for in-depth …

Disruptive Clinician Behavior: A Qualitative Descriptive Study Of Non-Native English-Speaking Nurses, Seyoung Baik

Dissertations

Background: Disruptive clinician behaviors among healthcare staff are an increasing concern, negatively affecting patient safety. In 2015, 16% of nurses in the U.S. were foreign-born (Shaffer et al., 2022), and 25% of New York and California nurses were immigrants (Shaffer et al., 2021). Nurses' migration to the U.S. has been exploding. Non-native English-speaking nurses experience complications, problems, and discord in their workplace with coworkers.

Aim: The purpose of this qualitative descriptive study was to explore and understand non-native English-speaking nurses’ experiences with disruptive clinician behaviors in the U.S.

Specific aims were to 1) create a comprehensive description of the experiences …

Efficacy Of, And Barriers To, Treatment Options For Pans/Pandas, Kayla E. Pray

Senior Theses

Background: PANS/PANDAS are pediatric autoimmune disorders that cause an acute-onset of OCD-like symptoms and/or severe restricted eating, as well as anxiety, irritation, deterioration of fine motor skills, hyperactivity, and other psychiatric symptoms. An estimated 1-2% of the pediatric population is affected. Currently, there is little research published on the treatment options for PANS/PANDAS and there is no evidence-based consensus on the best treatment option.

Purpose: This study aimed to discover the efficacy of, and barriers to, available treatment options for PANS/PANDAS.

Methods: A convenience sample of individuals diagnosed with PANS/PANDAS or their parent/caregiver was recruited anonymously through Facebook support groups. …

Peer Counseling For Perinatal Depression In Low- And Middle-Income Countries: A Scoping Review, Alexander Cuncannon, Kailyn Seitz, Aneel Signh, Aliyah Dosani

Brain and Mind Institute

Perinatal depression is associated with adverse maternal, newborn and child health outcomes. Treatment gaps and sociocultural factors contribute to its disproportionate burden in low- and middle-income countries (LMICs). Task-sharing approaches, such as peer counseling, have been developed to improve access to mental health services. We conducted a scoping review to map the current literature on peer counseling for perinatal women experiencing depression in LMICs. We searched CINAHL, MEDLINE, APA PsycINFO, Global Health and EMBASE for literature with no date limits. We included 73 records in our analysis, with most being systematic reviews and meta-analyses, randomized controlled trials and qualitative studies. …

A Scoping Review Of Substance Use Brief Interventions In Africa, Florence Jaguga, Sarah Kiburi, Eunice Temet, Matthew Aalsma, Mary Ott, Rachel Maina, Cyprian Mostert, Lukoye Atwoli, Juddy Wachira, Gilliane Kosgei

Internal Medicine, East Africa

Background: The burden of substance use in Africa is substantial. Brief interventions (BIs) are a recommended public health strategy for the prevention and early intervention for substance use problems. The objective of this scoping review was to map the literature on substance use BIs in Africa, identify gaps, and provide directions for future research.

Methods: The scoping review was guided by the Arksey O’Malley Framework and the PRISMA-Scoping review (PRISMA-ScR) guidelines. A search of five bibliographic databases (PubMed, PsychINFO, Web of Science, Cumulative Index of Nursing and Allied Professionals (CINAHL) and Cochrane Library) was conducted from inception until 1st November …

Increasing The Frequency Of Behavior Assessment To Reduce Physical Restraint, Breanne N. Ford

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to implement a system that routinely assesses for behavior changes in psychiatric patients presenting to the emergency department to improve staff intervention of escalating behaviors and decrease physical restraint use.

Background: The project was implemented in a 45-bed emergency department in a community-based hospital affiliated with a large hospital system in Houston, Texas.

Methodology: The project utilizes the Behavioral Activity Rating Scale (BARS) to assess patients' behaviors at routine intervals throughout shifts and a comfort cart that houses several non-pharmacological intervention items to use to de-escalate adverse behaviors. The staff …

Trauma-Informed Care: A Therapeutic Approach In Communication, Nicole A. Leonce

DNP Qualifying Manuscripts

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Screening, Brief Intervention, And Referral To Treatment For Pregnant Women, Rebekah Feeney

Dissertations

Abstract

Background: In the United States, 10-20% of pregnant women reported using drugs during pregnancy. Current recommendations are to screen for drug use in all patients and provide a brief intervention and referral to treatment. The purpose of this quality improvement project was to evaluate the impact of implementing a standardized screening, brief intervention, and referral to treatment (SBIRT) protocol for first-trimester pregnant patients who are seen in the obstetrical department.

Methods: The Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) screening tool was administered to first-trimester pregnant women, 13-45 years of age, seen in the obstetrical department from …

Screening For Depression Post Acute Coronary Syndrome, Alyssa Graham

Dissertations

Background: Acute coronary syndrome (ACS) and depression have profound impacts on patient outcomes. Patients who experience ACS are at increased risk of developing depression, which is associated with an increased risk of death and recurrent cardiac events. The evidence following ACS events promotes routine depression screening. The purpose of this project was to identify early depression in patients 65-99 years of age who had a recent diagnosis of ACS during their hospitalization.

Methods: This quality improvement (QI) project was a prospective descriptive observational design implementing a depression screening protocol to evaluate post-ACS referrals within 7-14 days of screening from February …

Postpartum Depression Screening In The Neonatal Intensive Care Unit At A Tertiary Pediatric Hospital, Abbie Bates

Doctor of Nursing Practice Final Manuscripts

POSTPARTUM DEPRESSION SCREENING IN THE NEONATAL INTENSIVE CARE UNIT AT A TERTIARY PEDICTRIC HOSPITAL

By

Abbie Kim Bates

Razel Bacuetes Milo, PH.D. DNP., FNP-C

Background: Postpartum depression (PPD) is a treatable mood disorder with an onset at 1-3 months after childbirth. In the United States, PPD occurs at a rate of 1 in 8 women and as high as 1 in 5 women in parts of the country. In unique populations such as the neonatal intensive care unit (NICU), PPD rates can be as high as 40%. The treatment rate for PPD is 50% with a sizable percentage of …

Improving Firefighter Health Through Education In Sleep Science, Elisabeth J. Filiss

Master's Projects and Capstones

Sleep impacts all aspects of life, from mental health to physical well-being to job performance. Nowhere is this more important than in the fire service, where extreme working conditions are the norm. One of 44 stations in a large fire department (XFD), Firehouse X, has 21 full-time members, six on duty per shift. A microsystem assessment of Firehouse X revealed poor sleep habits and environmental factors that are not conducive to quality sleep. The role of sleep in the fire service has recently been examined, and interventions aimed at improving firefighters’ sleep have been recommended.

This quality improvement project implemented …

Environmental Factors (Rurality, Distribution Of Prescribers, And Altitude) Of People Who Died By Suicide In Montana, 2013- 2022, Anne N. Brown

Electronic Theses and Dissertations

Introduction: Suicide is increasingly prevalent in rural areas across the United States, especially in the western Rocky Mountain states. The connection between suicide and rural residency is not well understood, nor is the relationship between the distribution of prescribers, altitude, and suicide. Purpose: This retrospective quantitative study aimed to describe the characteristics of individuals who died by suicide in Montana and investigate the associations among rurality, distribution of prescribers, altitude, and suicide rate. Methods: Montana suicide mortality data for 2013-22 was used to describe individual characteristics. A second dataset was created for each Zip Code Tabulation Area (ZCTA) level in …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

Transformative Learning: Changing Nurses’ Perceptions About People In Poverty, Jacqueline Debrew

Journal of Social, Behavioral, and Health Sciences

Background: Meaningful learning experiences with clients in poverty may help nursing students change their perceptions towards those experiencing poverty and, thus, provide unbiased, nonjudgmental care when they become nurses.

Purpose: The purpose of this research was to understand what learning activities and experiences nursing students found meaningful and led to a change in prior perceptions of people in poverty.

Methods: Guided by Mezirow’s Theory of Transformative Learning, accelerated BSN students enrolled in a mental health nursing course (n = 14) were assigned reflective journals throughout the semester on their assigned clinical experiences, which were analyzed for emergent themes.

Results: …

Improving Identification Of Complicated Alcohol Withdrawal Syndrome Using The Prediction Of Alcohol Withdrawal Severity Scale, Kristin Hagopian

Dissertations

Problem: Individuals who drink alcohol excessively are at great risk for alcohol withdrawal syndrome (AWS) when hospitalized. Symptoms and their severity differ for everyone, and research shows that the identification and treatment of AWS is challenging and often inadequate. Mild AWS is often overtreated, while moderate to severe AWS is often underdiagnosed and undertreated, placing individuals at risk for longer hospital stays, more time needed in critical care units, and a variety of unintended consequences.

Methods: This evidence-based practice project had a pre-post intervention design in which the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) was implemented to promptly identify …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

Improving Mental Health Outcomes For Amputees, Zachary Elmore

Dissertations

Problem: depression, anxiety, and other mental health disorders are more commonly diagnosed in the amputee population related to changes in mobility, activities of daily living, and quality of life (Turner et al., 2020.) As the amputation population is projected to reach over 3 million Americans in the next 25 years, additional screening is imperative to identify patients at high-risk for mental health deterioration (Ziegler-Graham et al., 2018).

Methods: this was a project that included screening all patients with the Personal Health Questionnaire for Depression (PHQ-8) meeting the inclusion criteria of being admitted to 7500 Vascular Surgery at Barnes-Jewish …