Psychiatric and Mental Health Nursing Commons^™

Improving Post-Discharge Engagement Of Mental Health Patients In The Veterans Affairs South Texas Healthcare System, Nneoma Lewis

Doctor of Nursing Practice

Discharge from a hospital is a high-risk period for mental health patients, as 20% experience an adverse event within 30 days of discharge. Poor discharge engagement can lead to complications for recovery, which include an increased risk for readmissions, longer length of stay, increased risk for suicide, and death. Hospital stays cost the United States $377.5 billion dollars per year; there is pressure for hospitals, health plans, and providers to examine the admission and discharge processes to improve healthcare delivery, transition of care, and patient health outcomes. At a South Texas VA, 67.66% of mental health patients attended all their …

Implementation Of A Protocol To Improve The Intake Assessment And Treatment With Suboxone Among Patients’ Dependent On Opioids On Two Mental Health Crisis Units, Maeghan Dillon

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: In 2021,106,699 people died from a drug overdose and of these deaths, over 75% were related to illicit or prescription opioids (Centers for Disease Control, 2023). At two in-patient community crisis stabilization units for psychiatric care, many patients have a comorbid diagnosis of a substance use disorder and another mental illness. Treatment with Buprenorphine/naloxone (Suboxone) is associated with decreased opioid overdoses and related deaths; however, Suboxone inductions have not been a part of admission treatment.

Methods: This quality improvement (QI) project initiated a Suboxone protocol for eligible patients on two crisis in-patient stabilization units. The outcomes …

Anxiety Screening At A Psychiatric Inpatient Facility: A Quality Improvement Project, Irene Akwitti

Doctor of Nursing Practice

Background. Generalized anxiety disorder is characterized by persistent anxiety and uncontrollable worry occurring more days than not for a minimum of 6 months (Patriquin & Mathew, 2017). Presently, anxiety screening and evidence-based practice treatment for adults are suboptimal. It is impossible to overemphasize the importance of early diagnosis and prompt treatment of generalized anxiety disorder in patients. Purpose. The purpose of this quality improvement project was to implement the Generalized Anxiety Disorder-7 (GAD-7) screening tool, a validated, evidence-based instrument, in a psychiatric inpatient facility to improve early detection and treatment of anxiety disorders in patients. Methods. Staff members were educated …

Utilizing A Validated Screening Tool And Treatment Protocol For Managing Agitation And Violence In A Psychiatric Emergency Services Unit, Zarah Ashcroft

Doctor of Nursing Practice

Background and Significance. Agitation is a significant concern in psychiatric units. If not detected early, agitated individuals are at high risk for becoming aggressive and violent, potentially causing harm to themselves, hospital staff, and property. The Psychiatric Emergency Services unit receives agitated and violent patients with psychiatric illnesses and substance use disorders. Purpose/Goal/Objectives. This quality improvement project aimed to implement a treatment protocol using the Broset Violence Checklist (BVC) to promote the early identification and management of potential for patient violence and aggression. Methods/Key Activities. Staff education for the nurses and providers on assessing patients at risk for aggression and …

A Quality Improvement Project To Screen For Food Insecurity In Adults With Anxiety Or Depression, Kelsie Evelyn Kroll

Doctor of Nursing Practice

Background Food insecurity is the limited availability and inconsistent accessibility of healthy foods (Coleman-Jensen et al., 2022a). Food insecurity contributes to mental health problems. Individuals with food insecurity have greater odds of screening positive for depression and anxiety (Wolfson et al., 2021). The Hunger Vital Sign™ screening tool is a 2-questions evidence-based tool used to identify food insecurity (Hager et al., 2010). Purpose. Implement the Hunger Vital Sign™ tool at a non-profit behavior health clinic to identify food insecurity in adults who screened positive for anxiety or depression, offer resources for them to obtain nutritious food, and provide additional information …

Implementation Of The Mood Disorder Questionnaire In A Psychiatric Inpatient Facility, Sandy Ann Harris

Doctor of Nursing Practice

Background. Bipolar disorder is a combination of multiple mood disorders associated with high suicide rates. The mood disorder questionnaire is a reliable, cost-effective, and time-effective screening tool to aid in diagnosing bipolar disorder (Carvalho et al., 2015; Miller & Black, 2020). Purpose. To implement the mood disorder questionnaire during admission to improve the accuracy of diagnosing bipolar disorder among providers in patients without a history of bipolar disorder. Goal. To increase the utilization of the mood disorder questionnaire thereby increasing bipolar disorder diagnosis accuracy. Objectives. 100% of the team will attend an in-service on the project; 60% of patients without …

Reducing The No Show Rates For Mental Health Appointments Among Young Adults, Johnnie Carrico

Student Scholarly Projects

Practice Problem: Missed patient appointments have become an increasingly significant issue for healthcare organizations, private practices, and clinics. No show appointments can negatively impact the operational functions of these organizations including lost revenue. The clinical practice site’s pre-intervention no-show rate for young adult mental health appointments was 21%. The high percentage of missed mental health visits has resulted in both lost revenue for the clinic and disruptions in patient care.

PICOT: The PICOT question that guided this project was: In young adults 18-25 years with mental health appointments (P) how does patient preferred appointment reminders (I) compared to …

Body Dysmorphia Screening Tool For Aesthetic Treatments, Brandi Harper

MSN Capstone Projects

This evidence-based project includes a discussion of Body Dysmorphic Disorder (BDD) or body image disturbance as part of pre-treatment screening in medical facilities providing appearance-altering procedures and aesthetic treatments to adult patients. The information provided serves as the foundation for endorsing the adoption of a BDD screening tool into clinical practice to increase the identification of body dysmorphia, thereby facilitating proper referral, diagnosis, and treatment to aid in patient safety and satisfaction and limit medico-legal imputations. The discussion presented here is supported by evidence-based research. It focuses on BDD prevalence and significance amongst adult patients and highlights validated screening tools …

Stress And Coping Strategies Adopted By Mothers Of Children Admitted In Pediatric Intensive Care Unit., Anisha P. R, Remya U R

Manipal Journal of Nursing and Health Sciences

Introduction: Planned or unplanned hospitalization increases the family’s stress and anxiety level. Hospitalization creates stress as they interrupt normal routines and place increased demands on parents who must further divide their time between the normal responsibilities and their hospitalized child. Many parents feel a lack of control and sense of powerlessness when their child is hospitalized. Objectives: The objectives of the study were to identify the stressors and coping strategies adopted by mothers of children admitted in pediatric intensive care unit and to determine the co-relation between stressors and coping strategies adopted by mothers of children admitted in PICU. Methods: …

Psychosocial Impacts On Parents Of Mentally Challenged Children At Mangaluru, Sooraj Kookal Mr

Manipal Journal of Nursing and Health Sciences

Abstract

Introduction: Intellectually disabled children upset the mental, physical, social, and financial outlooks of the family in terms of their rearing and future. The support systems surrounding the parents of mentally retarded children play a vital role to lessen the burden associated with their special child. This study brings up some light on the psycho-social impacts on parents of Mentally challenged children who were attending special schools at Mangaluru. Objective: The main objective of the study was to assess the psychosocial impacts on parents of mentally challenged children. Further, to find the association between the psychosocial impact on …

Targeting Loneliness In Older Adults With Weekly Socialization, Tanja Johnson

Dissertations

Problem: Loneliness related to social isolation among the older adult population has become an increasing health concern with few interventions available for the general population. Loneliness has been directly associated with depression, poorer physical health outcomes, and overall quality of life.

Methods: The purpose of this study is to evaluate loneliness in the older adult population residing in a senior living community in an urban area in Missouri. Weekly one-on-one socialization, ranging from 45-60 minutes, will be implemented over 6 weeks, with pre and post-intervention screening for loneliness with the 28-item Visit-A-Bit (VAB) screening tool. Approval was received by both …

Risk And Protective Factors To Well-Being In Foster Care Youth Prescribed Psychotropic Medication In A Wraparound Program Of Care, Ann Reali Stratton

Dissertations

Background: Youth in foster care are prescribed psychotropic medications at higher rates and are more likely to experience disruptions to their medical care. Wraparound models of care have been shown to improve outcomes for youths on psychotropic medications, however, these methods have proved difficult to replicate in the foster care population. Government policies have called for better oversight in the foster care population and in response programs have been implemented, however, there remains little research for these programs. Objective: This research will evaluate the characteristics of foster care youth as they enter a Wraparound model of care and the predictive …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

Medication-Assisted Therapy And First Episode Psychosis: Evaluating Treatment And Readmission Rates: A Scoping Review, Whitney Nichole Trotter Ms, Bsn, Rdn/Ldn, Rn, Margaret Carrie Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background:

There is limited research aimed at addressing the reoccurrence of admission rates for first-episode psychosis. Research shows that early interventions for first-episode psychosis lead to remissions and prevention of relapses. Research also estimates that approximately one-half of first-episode clients have a history of cannabis abuse or dependence and one-third have a current cannabis use disorder (Wisdom et al., 2011). This study looks to determine whether Medication-assisted therapy (MAT) impacts readmission rates for patients who have substance use disorder and first-episode psychosis within six months of discharge.

Methods:

A comprehensive literature search was conducted using several electronic databases, including PubMed, …

The Addition Of Nature To The Patient's Healing Regimen, Katelyn Lewis, Audrey Henry

Scholars Week

Through our scholarly research, we have found many benefits to the use of nature to help facilitate healing within patients. Our project aims to spread awareness of the positive aspects of nature during the healing process. Specifically, our research focuses on healing gardens and outside therapy for patients. Our presentation is based upon Nightingales' theory of the environment. Our hope is that facilities will implement the addition of nature to the patient's plan of care.

Mental Health Suicide In Alabama, Michael Schurdell

University Faculty and Staff Publications

Mental health and suicide are significant issues in Alabama, a state that ranks 46th out of the 50 states and Washington D.C. in access to mental health services. Alabama’s suicide rate is 59% higher than its homicide rate of 8.3%. This crisis is particularly acute among Caucasian males aged 45-54, who account for 71% of suicides; this demographic is four times more likely to commit suicide than females and three times more likely than African Americans. High suicide rates correlate to a lack of available resources across the state, especially in rural communities. The closure of mental health facilities has …

Nurse-Led Education For Postpartum Depression In Primiparous Asian-American Mothers, Colleen Peralta

Nursing | Student Research Posters

The postpartum period is a critical point when women remain a vulnerable in the hospital setting. This stems from various physical, emotional and psychological changes that women face after childbirth, when patient support and attention is vital. For instance, the postpartum stage poses risk to women for complications, such as postpartum depression (PPD). When left untreated and misdiagnosed, PPD can lead to adverse maternal outcomes, such as: problems with mother-infant bonding, difficulty breastfeeding, and an increased risk for suicide (Mayo Clinic, 2022).

Asian-American mothers with postpartum depression face unique challenges, including the stigma surrounding mental health, which remains prevalent within …

Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah, Jasmit Shah, Jumaa Bwika, Sayed Karar

Internal Medicine, East Africa

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods: This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ …

Introduction Of A Policy Adherence Plan In An Outpatient Buprenorphine Treatment Clinic., Stacie Switzer Cheney

Doctor of Nursing Practice Papers

Abstract

Background: Medication-Assisted Treatment (MAT) is one of the most effective pharmacological therapies for opioid dependence. Regular urine drug screening to include random urine drug screens at least once a month is a key factor in improving quality care for those receiving treatment in an outpatient MAT clinic.

Problem: A rural outpatient MAT clinic has a current random urine policy that is not being utilized when treating clients with Opioid Use Disorder (OUD). This increases the risk of diversion and misuse of buprenorphine/naloxone (Suboxone), thus increasing the risk of overdose and death for OUD patients.

Environment: This project was implemented …

Implementing Trauma-Informed Care Curriculum In A Doctoral Nursing Program, Mary D. Brown

Dissertations

Purpose: Trauma is highly prevalent with 70% of individuals encountering at least one traumatic event during their lifetime and approximately 30% experiencing four or more events (Wheeler & Phillips, 2021). Despite the dramatic impact of trauma, there is minimal literature to assist nurses in caring for patients with a trauma history. The purpose of this project was to evaluate the implementation of a virtual, asynchronous trauma-informed care (TIC) educational program for Doctor of Nursing Practice (DNP) students at a midsized, Midwestern public university using knowledge, attitudes, and competency scores as outcome measures.

Methods: This program evaluation (PE) project was an …

Acute Agitation Intervention Tool For Reduction Of Polypharmacy, Brooks J. Propst

Dissertations

Introduction: Patients with behavioral health diagnoses are among the highest risk for
aggression. For pediatric patients with behavioral health needs, urgent treatment is
needed for aggressive behavior, due to the potential unwanted outcomes. The purpose of this Quality Improvement (QI) pilot project was to implement an Acute Agitation Intervention Tool that uses the Broset Violence Checklist (BVC) to guide
pharmacological intervention for mild and moderate to severe agitation in pediatric
patients with behavioral health needs ages 8 to 18 to decrease the number of medications that patients are getting per agitation event over a 12-week period.

Methods: This QI included …

Attention-Deficit Hyperactivity Disorder: Improving Outcomes Through Early Identification, Tina Lusk

Dissertations

Problem: Failure to identify and treat attention-deficit hyperactivity disorder (ADHD) is associated with academic underachievement, social difficulties, negative physical and mental health effects. Evidence suggests approximately 3% of a broad-based population sample and roughly 13% of an at-risk population are undiagnosed despite significant symptomology (Downey & Zun, 2018; Madsen et al., 2018; Okumura et al., 2019). The United States (U.S.) has no structured screening system for ADHD. Consequently, children receive no referral for diagnosis or treatment to mitigate its effects.

Methods: The Institute for Healthcare Improvement (IHI) Model for Evidence-Based Practice using the Plan Do Study Act (PDSA) cycle guided …

Evaluation Of A Substance Abuse Screening Tool In The Pediatric Emergency Room, Jody Sims

Dissertations

Abstract

Background: Substance abuse among adolescents is one of the most serious social health problems in the United States. The prevalence of alcohol use in adolescents is as high as 80%, while opioid overdose deaths among adolescents have risen by greater than 50% in the last 10 years. Alcohol, tobacco, and other substance use has also increased among youth and is not being properly evaluated in the pediatric hospital setting. The purpose of this project was to evaluate the use of a substance abuse screening tool with SBIRT trained staff in the pediatric emergency room setting.

Methods: The CRAFFT substance …

Decreasing Restraint Times On An Inpatient Psychiatric Unit., Maria Siegel

Doctor of Nursing Practice Papers

Restraints are widely used on inpatient psychiatric units when psychiatric patients exhibit escalating behaviors. Physical restraints, including seclusion, increase patients’ risk for injury and psychological trauma. Acute inpatient psychiatric units should aim to use restraints only as a last resort and for as little time as possible to keep the patient and others safe. The literature suggests that ways to decrease restraint rates on inpatient psychiatric units include risk assessment for early identification and proper use of alternative measures. Nursing staff education has been proven to play an important role in decreasing overall restraint times on inpatient psychiatric units. The …

Increasing Music Therapy Referrals In A Surgical Intensive Care Unit., Brandi Cecil

Doctor of Nursing Practice Papers

Medications have been the primary intervention in intensive care unit patients due to the fact that the patients are often unconscious, critically medically ill, or unable to actively participate in nonpharmacological treatment. Researchers have found the integration of music therapy in patient care has helped ease pain, anxiety, and stress, and has been useful in vital control, such as decreasing heart rate and respiration count. A study was conducted in a surgical intensive care unit (SICU) to examine the benefits of increasing music therapy consults. Critical care nurses were educated on the advantages of utilizing interdisciplinary care by consulting music …

Implementation Of A Postpartum Depression Screening Protocol, Samantha Abercrombie

Doctor of Nursing Practice Projects

Background: Postpartum depression (PPD) is a major depressive disorder that can occur after having a baby and anytime during the first year postpartum (Centers for Disease Control and Prevention [CDC], 2021). Symptoms of PPD may include anger, crying more than usual, withdrawing from family, inability to bond with the baby, feelings of anxiousness, or thoughts of the mother harming herself or the baby. PPD can yield many challenges and hinder daily living activities. Recent research by the CDC (2021) estimates that 1 in 8 women experience manifestations of PPD. Findings also suggest that 1 in 5 women were not …

Improving The Mental Health Nursing Competencies Of Nurses Caring For Patients With History Of Substance Use Disorder In Long-Term Care Settings, Nancyver Lafleur-Omeler

Doctor of Nursing Practice Projects

Background

While nurses are often on the front lines of working with patients with a history of substance use disorders (SUD), most have limited training in this area. Nurses who work in Long Term Care (LTC) settings are often challenged to resolve the practical issue of needing more competency in caring for SUD patients. Horner et al. (2019) agreed that the deficiency of mental health knowledge and skills in healthcare workers is linked to decreased quality of care, which can diminish patient outcomes. This lack of competency must be addressed (Margoliese & Vandyck, 2019).

Purpose

The goal of this project …

The Association Between Pelvic Floor Dysfunction And Mental Health In Natal Females With A Focus On Native American Populations, Lexxie Gramke

Dissertations

Purpose

Over half of natal females in the United States suffer from pelvic floor dysfunction (PFD). PFD can increase risk of mental health sequelae; however, no studies have been conducted examining the association between mental health and PFD in the Native American (NA) population. This dissertation aims to evaluate the association between PFD, with a focus on overactive bladder (OAB), and mental health in females with specific attention to NAs.

Methodology

A current state of the science review examined the literature for associations between OAB with depression and anxiety in females. Utilizing this literature review, a theoretical model was constructed …

Social Identities And Campus Belonging As Predictors Of Flourishing Among College Students, Christine Gilchrist

Dissertations, Theses, and Capstone Projects

Annual data since 2012 shows college students’ flourishing (a measure of psychological well-being) in continuous decline, with 2022 showing the largest decrease. Since the knowledge base of the predictors of flourishing is limited, how college executives can best address this issue is unclear. Variations in flourishing have been observed in studies that examined the relationship between food insecurity (DeBate et al., 2021), race/ethnicity (Lipson et al., 2018, 2022; Nyunt et al., 2022; Parr, 2022), immigration status (Cadenas & Nienhusser, 2021), as well as gender identity and sexual orientation (Parr, 2022). The intersectional impact of demographic and social identities has not …

The Effects Of Music Therapy On Elderly Adults With Dementia, Jeante J. Jackson

Dissertations, Theses, and Capstone Projects

As people age, the brain is more susceptible to changes that diminish cognitive function. In recent years neuroscience has found convergent evidence between music therapy and brain architecture, as it has shown the generation of new connections in the brain or a reorganization and possible strengthening of existing connections already in the brain. However, the literature regarding music training’s effects on executive control, selective attention, and speech processing is lacking particularly when it comes to older populations.

This study investigated Verbal Working Memory, Visuospatial Attention and Task Initiation, and Auditory Selective Attention in a 91-year-old adult (B.P.) diagnosed with dementia. …