Psychiatric and Mental Health Nursing Commons^™

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 …

The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe

Dissertations, Theses, and Capstone Projects

The purpose of this research study is to explore the lived experience of using opiates, as described by young adults aged 18 to 25 years. Over the last 2 decades, opioid use disorders (OUDs) and opiate overdose deaths have increased dramatically in the United States. What used to be a problem primarily contained to minority groups in poor inner-city areas is now increasingly common in all races, genders, ages, and classes. There has also been an alarming increase in opiate use—including fentanyl, both legal and illegal—among young adults. While much of the literature has been focused on the opiate use …

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. …

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 …

Implementation Of The Columbia-Suicide Severity Rating Scale At An Outpatient Mental Health Practice To Increase Provider Confidence In Identifying Suicide Risk, Lauren Reed

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to implement the Columbia-Suicide Severity Rating Scale (C-SSRS) as part of routine patient assessment at an outpatient mental health practice to increase the likelihood of identifying clients at risk for suicidal behavior and increase provider confidence in screening for suicidal behavior. The study site is a Southern California-based outpatient mental health practice that employs a variety of clinicians, including psychiatric-mental health nurse practitioners, to provide mental health care to clients across the lifespan.

Background: Approximately 57% of individuals who die by suicide had at least one contact with …

Implementation Of The Generalized Anxiety Disorder 2-Item Screening Tool For Adult Patients In An Underserved Outpatient Cardiology Clinic, Leila Joint

Doctor of Nursing Practice Final Manuscripts

Background: 11.7% of adults aged 18 and over have regular feelings of worry, nervousness, or anxiety. Anxiety can often present with somatic symptoms. The rates of misdiagnoses are high with symptoms often attributed to physical etiologies. Early recognition and treatment of anxiety can improve quality of life, prevent complications and reduce health care costs.

Purpose of Project: Implementation of the Generalized Anxiety Disorder 2-item (GAD-2) screening tool in a fast-paced underserved outpatient cardiology clinic for adult patients presenting with chest pain and/or palpitations without documented history of anxiety. The purpose of this project is to improve the utilization …

Implementation Of Clinical Institute Withdrawal Assessment: Alcohol Revised (Ciwa-Ar) Education Program In A Crisis Stabilization Unit, Amanda Dehart

Doctor of Nursing Practice Final Manuscripts

Background: At this time the crisis stabilization Units do not currently utilize the Clinical Institute Withdrawal Assessment: Alcohol Revised tool with patients who may experience Alcohol Withdrawal Syndrome. Patients with alcohol use disorders have a high comorbidity rate with psychiatric disorders (Butterfield, et al, 2020). The Clinical Institute Withdrawal Assessment: Alcohol Revised or CIWA-Ar is currently the most widely used assessment tool in the psychiatric setting when assessing patients who may be experiencing Alcohol Withdrawal Syndrome (Pribék, et al, 2021) .

Purpose of Project: The purpose of this project is to measure pre and post -education knowledge of the registered …

Anxiety And Agitation In Adult Patients Admitted To An Emergency Room During The Covid-19 Pandemic, Doris L. Asombrado

Dissertations

Purpose: The purpose of this retrospective correlational study was to identify the relationship between COVID-19 status and the prevalence of anxiety-agitation with select sociodemographic and clinical characteristics in adults admitted to the ED during the pandemic (03/01/2020 through 12/31/2020).

Background: COVID-19 infections combined with the WHO and CDC recommendations to mitigate spread have had deleterious psychosocial and economic outcomes with the risk of subsequent COVID-19 related mental illness. Studies indicate one in three adults experience anxiety or depression.

Methods: This retrospective correlational study reviewed 2,572 psychiatric admissions from a Southern California ED during the pandemic from March 1, 2020 through …

Implementation Of An Implicit Bias Training In A Doctor Of Nurse Practitioner Program, Macdana Selecon

DNP Qualifying Manuscripts

Background: Implicit bias in healthcare delivery is the unconscious prejudice individuals might feel about another person or group. All healthcare providers are susceptible to implicit bias which can negatively influence patient-provider communication. Implicit bias is linked to disparities in maternal health outcomes. According to the CDC, the maternal mortality rate for non-Hispanic Black women is 2.9 times higher than the rate for non-Hispanic White women (Hoyert, 2022).

Problem: Implicit bias (IB) training is not provided in all graduate nursing programs. As a result, graduate nursing students are not prepared to manage IB during clinical rotations and post-graduation, thus, are at …

Trauma-Informed Treatment For Alcohol Use Disorder: Improving Long-Term Recovery, Aline M. Bales

Doctor of Nursing Practice (DNP) Projects

Background: This DNP project aimed to assess the feasibility of implementing trauma-informed care to Ria Health's telehealth AUD MAT recovery treatment model for patients with co-occurring PTSD, targeting high relapse rates due to cravings. Trauma-informed care addresses traumatic histories that can potentiate emotional dysregulation leading to maladaptive coping responses manifesting as cravings with addiction memory.

Methods: An integrated review assessed the prevalence of co-occurrence of AUD and PTSD, assessed interest in Ria Health patients, patients recruited from Ria Health if they mentioned cravings, offered concurrent trauma-informed care with medicated assisted treatment for 16-20 sessions, trauma-informed care used Polyvagal Theory techniques …

Save The Children Community Health Worker Program – Adverse Childhood Events Prevention, Jieun Lee

Doctor of Nursing Practice (DNP) Projects

Background: Adverse childhood experiences (ACEs) are potentially traumatic events that occur between the ages of 0 to 17 in which are directly associated, in a dose–response manner, to many of the most common and serious health problems in the United States.

Local Problem: 62% of California residents have experienced at least one ACE, and 16% have experienced at least four ACEs. ACEs are linked to nine of the ten leading causes of death in the United States Adults with four or more ACEs are 37.5 times more likely to attempt suicide, 3.2 times more likely to have chronic lower respiratory …

Mental Health Services: Reaching The Homeless, Gurdeep Mann

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Serious mental illness (SMI) and substance use disorder (SUD) are two common findings among the majority of those experiencing homelessness in the Stanislaus County.

Local Problem: Emergency shelters typically do not provide mental health services on-site, however, a collaboration between First Behavioral Health Urgent Care Center (FBH) and We Care Program Turlock (WCPT) was established to provide mental health services on-site.

Method: The WCPT case manager as part of a Doctor of Nursing Practice (DNP) quality improvement project implemented Assertive Outreach Model interventions to increase utilization of mental health services and established long-term relationships.

Interventions: Frequent contact with …

The Use Of Therapeutic Gardening In Addiction Recovery, Sophia Agne

Master's Projects and Capstones

Problem: Numerous recent studies have emerged detailing the benefits of horticultural therapy on mental health and wellness. Despite this, substance use disorder treatment facilities rarely include an outdoor component in their programming. The project seeks to examine the advantages of incorporating therapeutic gardening as a complementary part of addiction treatment.

Context: The microsystem where the study was conducted was at a 32-bed residential substance abuse treatment facility for adult men who have previously been involved in the criminal justice system. The treatment approach employed at the facility aligns with the Integrated Dual Disorder Treatment (IDDT) curriculum, which emphasizes mental health-informed …

Therapeutic Gardening For Addiction Recovery, Hayley Milleson

Master's Projects and Capstones

The following study examines the potential benefits of implementing therapeutic gardening and outdoor activities as a supplemental resource for adult males with a history of substance abuse issues who have been affected by the criminal justice system and are seeking sobriety while in a residential treatment program. The goal is to investigate how therapeutic gardening can add to traditional addiction treatment methods. Through a review of current evidence-based practice, this study focuses on how alternative interventions such as therapeutic gardening and outdoor activity can improve overall mental health and well-being, promote a sense of community, improve social connections, alleviate stress …

Therapeutic Gardening For Addiction Recovery, Hugo A. Rivera Lopez

Master's Projects and Capstones

Problem: The use of evidence-based alternative forms of therapy like horticulture therapy and therapeutic gardening is underutilized in substance use recovery programs in the United States. As the country continues to struggle with addiction, it is important that recovery programs look to and incorporate these alternative therapies into official curricula. Currently, 46.3 million individuals living in the United States are living with a substance use disorder (U.S Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, 2022).

Context: The intervention was implemented at an all-male substance use treatment facility in San Jose, CA that houses up …

Therapeutic Gardening For Mental Health In Substance Use Recovery, Stephanie E. Schafer

Master's Projects and Capstones

Abstract

As the clinical nurse leader (CNL) in this project, I used the “[CNL]

Essential 1: Background for Practice from Sciences and Humanities” (Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice, 2013) and its competencies to focus on designing nursing care for a clinical or community-focused population based on biopsychosocial, public health, nursing, and organizational sciences and to synthesize evidence for practice to determine appropriate application of interventions across diverse populations. With the help of the CNL competencies and collaboration with the healthcare team, we created and implemented a therapeutic garden for residents in a substance use …

Exploring The Effects Of Psychosocial Factors And Relationships To Postpartum Depression Symptoms Among Iranian Immigrant Women Living In Canada: A Cross-Sectional Study, Monica Gola

Electronic Theses and Dissertations

Introduction: Immigrant women’s health garners attention as migration creates changes in social networks and parenting needs. The effect of psychosocial factors, such as maternal self-efficacy, measured by ability to manage parenting responsibilities, social support and cultural postpartum practices on postpartum depression symptoms are not well known in Canadian immigrant women. Methodology: A cross-sectional descriptive survey design guided by Bandura’s Reciprocal Determinism was used to explore the relationships between psychosocial factors including: maternal self-efficacy, social support, cultural postpartum practices; and symptoms of postpartum depression (PPD) among recent Iranian immigrant women living in Canada. Results: A total of 114 participants completed the …

Implementing The Timed Up And Go Test To Prevent Falls, Shamika Allen

Doctor of Nursing Practice Projects

Falls are the most reported injury within the geriatric population. Behavioral health patients have the most injurious falls, with falls impacting multiple things such as staffing, cost, injury, and quality of life for the patient (Ocker et al., 2020). Currently, the standardized fall assessment for new patients upon admission is the Morse Fall Scale (MFS). This fall assessment was intended to assess the level of fall risk for patients who are on an acute medical floor during their hospital stay. The Timed Up and Go test (TUG) is a fall assessment that has been used in geriatric patients to assess …