Psychiatry and Psychology Commons^™

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Evaluating Sbirt In A Behavioral Health Urgent Care, Christina L. Williams

Dissertations

Background: Adolescent substance use (SU) is a major health concern. Most youth who engage in alcohol and other SU do not meet criteria for SU disorder (SUD). Nonetheless, evidence shows SU during adolescence impacts cognitive, social, and emotional development, increases risk of physical injury, and may progress to SUD in adulthood. Only half of clinicians properly screen adolescents for SU; those identified with SUD often receive no intervention. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based intervention to address this problem. The purpose of this project was to evaluate implementation of SBIRT using CRAFFT 2.1+N, a SU …

Visualizing Depressive Symptom Improvement: Implementing The 17-Item Hamilton Depression Rating Scale, Briana Raterman

Dissertations

Visualizing Depressive Symptom Improvement: Implementing the 17-Item Hamilton Depression Rating Scale

Abstract

Problem

Depression, a mental health diagnosis, has affected about 18.5% of adults (Villarroel & Terlizzi, 2020). Ketamine, a medication initially used as an anesthetic, has improved depressive symptoms in individuals struggling with treatment-resistant depression.

Method

This quality improvement (QI) project used the 17-item Hamilton Depression Rating Scale questionnaire to assess depressive symptom changes in patients receiving intramuscular ketamine for treatment-resistant depression. The questionnaire was administered to patients pre-and post-intramuscular ketamine administration. The data was collected on injections one, three, and six on each participant’s set schedule of injections …

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

Evaluating Patient Health Questionnaire-9 (Phq-9) Use In Burn Survivors, Chelsey Friend

Dissertations

Problem: A burn injury affects both psychological and physical health, resulting in a greater than 50% major depressive disorder morbidity. The purpose of this quality improvement (QI) project is to evaluate the use of the Patient Health Questionnaire-9 (PHQ-9) in adult burn survivors, with an aim to increase the use of the screening tool.

Methods: A mixed-methods pre/post-survey design with an educational component was utilized to assess nurse knowledge, confidence, willingness, and barriers to completion of the PHQ-9. Aggregate data were collected to determine PHQ-9 completion rates for patients admitted to and discharged from the unit during the two months …

Screening For Suicide Risk In The Outpatient Electroconvulsive Therapy Population, Cerah Nagata

Doctor of Nursing Practice Final Manuscripts

TITLE: Screening for suicide risk in the outpatient electroconvulsive therapy population

BACKGROUND: Reducing risk for suicide continues to be a national hospital patient safety goal. Suicide is the 10th leading cause of death in the United States and suicide rates have increased 33% in the last decade. It has been found that 83% of those who die by suicide received healthcare services in their last year of life, thus healthcare providers are uniquely suited to play a role in identifying suicidality. The Columbia-Suicide Severity Rating Scale (C-SSRS) is a validated tool developed by Columbia University, University of Pennsylvania, and the …

Implementation Of Nola Pender’S “Clinical Assessment For Health Promotion Plan” To Increase Patient Self-Efficacy, Weight Loss And Health Promoting Behaviors Such As Improving Nutrition And Increased Physical Activity In Obese Women In A Weight Loss Clinic, Christine Ngwazini

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to review research-based studies on Nola Pender’s Health Promotion Model for weight loss and implement the evidence. The goal was to increase patient self-efficacy, weight-loss, and health promoting behaviors such as improved nutrition and increased physical activity among obese women in a weight loss clinic.

Background: Obesity leads to an increased risk of heart disease, stroke, type 2 diabetes, cancer, and premature death (CDC, 2020). From 2016 to 2017, 42.4% of people in the United States were obese (2020). Worldwide, over 650 million people were obese …

A Description Of Impostor Phenomenon In Certified Registered Nurse Anesthesiologists, Jeffrey R. Darna

Dissertations

Background: Imposter Phenomenon (IP) is an evolving, multidimensional construct defined as self-perceived intellectual phoniness and professional ineptitude frequently experienced by individuals working in high performance or competitive environments. IP consequences include psychological distress, role under-optimization, and professional paralysis. Certified Registered Nurse Anesthesiologists (CRNAs) are at risk for impostorism; however, IP presence, intensity, and career effects are unknown.

Purpose: The study measured IP in CRNAs and determined the relationship between IP and select sociodemographic and practice variables.

Methods:

Design: A descriptive, cross-sectional correlation design measured IP using an Internet-based survey from a random sample of 170 members of the American …

Increasing Mental Health Literacy In The Black Church, Jonathan Allotey

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project was to increase mental health literacy, assess stigmatizing attitudes, and increase help seeking behavior in leadership within an African American church.

Background: The Black church has historically been a central institution for community support and leadership within these churches are often ill equipped to address the mental health needs of congregants. African Americans underutilize mental health services and are reported to have more chronic mental illnesses. Lack of mental health literacy may result in difficulty recognizing the risk factors, signs, symptoms, and treatments related to specific mental illnesses.

Evidence Based Intervention and Methods: Participating …

A Qualitative Study On Nurse Facilitators Of Mind-Body Skills Groups, Paula D. Blake-Beckford

Mindfulness Studies Theses

The Center for Mind-Body Medicine (CMBM), founded by Dr. James Gordon, provides communities with evidence-based Mind-Body Skills Groups (MBSGs) that foster self-care, self-awareness, and self-expression. MBSGs range from 8 to 12-week series on various mind-body practices wherein group members meet, practice, and reflect on the impact of mind-body skills in their lives. Research has demonstrated that participants in MBSGs have positive outcomes. Healthcare professionals (HCPs), especially nurses, gain resiliency from MBSGs. As facilitators of MBSGs, nurses develop essential skills transferable to clinical and educational settings. MBSGs are therapeutic for adult participants with chronic stress. Prior to this thesis, only one …

The Lived Experience Of Second Victim Crnas, Michael Neft

Electronic Theses and Dissertations

A second victim is a health care provider who has been involved in a critical event. A

critical event is a clinical situation in which an unforeseen clinical outcome occurs, or

the clinical deterioration of the patient takes place for many different reasons. The

patient and his/her family are the first victims. The health care provider(s) involved in

the event are second victims. After such an event, the healthcare provider may

experience a constellation of negative emotions, such as guilt, sadness, depression,

somatic symptoms, hypervigilance, and fear. Most second victims require support to

cope with the adverse clinical situation. Second …

Implementation Of Routine Screening With Patient Health Questionnaire 9 (Phq-9) Of Adults With Crohn’S Disease, Jo A. Muller-Krause

Doctor of Nursing Practice Projects

Introduction: Mild levels of depression have been measured with screening tools at rates of 15-24% in adults with Crohn’s disease (CD). The spectrum of the impact of depressive symptoms is measurable and documented for those with CD. Patient perspectives support the integration of psychological care, and the Patient Health Questionnaire 9 (PHQ-9) is a well validated tool for the measurement of depressive symptoms.

Purpose: Increase depression screening of adult CD patients in the outpatient gastroenterology clinic and evaluate the provider perspectives regarding PHQ-9, depression, and CD.

Conceptual Framework: The Johns Hopkins Nursing Evidence Based Practice (JHNEBP) Model was selected as …

Reflective Journaling Intervention To Impact Self-Awareness, Professional Health, And Overall Well-Being In Nurses, Brittany M. Langan, Katherine Keppen

Doctor of Nursing Practice Projects: College of Nursing

Background. Burnout among nurses has been on the rise and was exacerbated with the pandemic. Reflective journaling after work may be a strategy to decrease feelings of burnout. Reflective journaling, as an intervention, has been shown to improve self-awareness, compassion fatigue, and burnout among nurses. The purpose of this study was to pilot a 4-week reflective journaling intervention in hospital-based nurses and describe participant professional quality of life, self-awareness, and overall well-being.

Theoretical Framework. The Theory of Reasoned Action (TRA) was chosen as the theoretical framework because it identifies the belief that performing a particular behavior will lead to a …

Screening And Follow Up For Postpartum Depression: How To Improve Practice, Mallory Matusik

Evidence-Based Practice Project Reports

Postpartum depression (PPD) is one of the most common mental health conditions, affecting one in seven women during their reproductive years (American College of Obstetricians and Gynecologists [ACOG], 2018). The purpose of this evidence-based practice (EBP) project was to improve screening and management of PPD using the Edinburgh Postnatal Depression Scale (EPDS) screening tool and a protocol for appropriate treatment and follow up care for PPD. A protocol was created by the project leader with information on screening and diagnosis, follow up, and treatment for PPD. The protocol also included information on how to assess for suicidal and/or homicidal ideation …

The Impact Of Psychological Interventions Given To Icu Patients To Help With Pain Management, Kelly Liu

Nursing | Senior Theses

Pain management among the critically ill population is a significant issue in the intensive care setting. Whether the pain is acute or chronic, nurses tend to be the first-hand responders to help with pain management in the intensive care unit (ICU). With barriers ranging from patients’ inability to verbalize pain to nurses’ experience with obstacles to assessment such as sedation, confusion, or other concerns, pain management is a serious issue. Although pharmacological interventions such as opioids and analgesics help with pain control, in this thesis, we will focus on the impact of nonpharmacological and psychological nursing interventions and how it …

The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell

Undergraduate Honors Theses

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression …

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

Nutrition On The Prevention And Treatment Of Depression, Gracie Polen

Nursing | Senior Theses

Today, the general population consumes a diet high in sugars, saturated fats, incomplete protein sources, and the tendency to exceed the bodies caloric requirements. The trend of obesity due to poor dietary habits is alarming. Mental illness has increasingly risen over the past decade. Specifically, the incidence of depression has reached a startling rate. The relationship between poor dietary intake and depression have grown together and it is imperative that methods are introduced to aid in resolving this issue. The prevention and treatment of depression needs to be explored through alternative methods. Healthier dietary choices have been shown to have …

Practicing Trauma-Informed Care In Nursing For A Better Outcome In Hospitalized Adolescents With Adverse Childhood Experiences And Trauma, Allysa Mia Fabricante

Nursing | Senior Theses

As nurses we want to give our patients the best care. That is why trauma-informed care (TIC) is important to include into nursing practice. TIC is a fairly new idea that addresses a patient's whole past and present life. Incorporating it into nursing practice can benefit patients who have adverse childhood experiences and trauma. Adverse Childhood Experiences (ACEs) are traumatic events that occur to a person starting from birth to 17 years old. In a hospital setting an adolescent patient can be triggered if ACEs and trauma is not properly addressed. The long-term effects of ACEs can affect adolescents into …

Family-Centered Psychosocial Care For Pediatric Oncology Patients, Jessica W. Casey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Psychosocial conditions are prevalent in pediatric oncology patients (Kahalley et al., 2013). Family and social support are essential aspects of a patient's health care outcomes (Merck & McElfresh, 2019). Anxiety and depression are common in pediatric oncology patients due to trauma during treatment (Pao & Kazak, 2015). These patients also can have preexisting developmental or behavioral conditions before starting treatment. Treatment side effects can also cause cognitive and behavioral changes (Nixon, 2014b). Nurses should be knowledgeable and confident in their ability to care for patients' psychosocial health and development. The purpose of this Doctor of Nursing Practice (DNP) project is …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …

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 …

Dnp Final Report: Adolescent Support For Healthy Living, Kristin S. Hudson

DNP Final Reports

Adolescents often make decisions that negatively impact their health and wellness. They do this for many reasons including impulsivity, underdeveloped communication and coping skills, feelings of invincibility, and a perceived lack of support. In adolescents, how does education and training related to risky behaviors compared to no education affect knowledge, skills, and understanding (KSU) of high-risk behaviors three months after instruction? Thirteen peer- reviewed articles were utilized in the body of evidence. A curriculum-based intervention was implemented. Outcomes include an overall increase in KSU in six key concepts including contraception, substances abuse, sexually transmitted diseases/infections, teen pregnancy, peer pressure, and …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

The Effects Of Exercise And Nursing Care On Postpartum Depression, Greyson Whaley

Epsilon Sigma at-Large Research Conference

Abstract

Introduction and Background: According to the Centers for Disease Control and Prevention (2020), “postpartum depression is depression that occurs after having a baby which is more intense and lasts longer than those of “baby blues,” a term used to describe the worry, sadness, and tiredness many women experience after having a baby.” It also states, “1 in 8 women report symptoms of depression after giving birth, about 1 in 5 (20%) women were not asked about depression during a prenatal visit, and over half (50%) of pregnant women with depression were not treated.”

Purpose Statement: The purpose of this …

Boarding Barriers For Psychiatric Patients In Emergency Departments, Emmeline B. Martin Bsn, Rn, Alison Rossano Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Objective To identify past or current literature about emergency department holds and psychiatric patients consisting of the evaluation of patient outcomes, satisfaction and equity of care. It is already known that shorter boarding times from the emergency department to a psychiatric unit have positive patient outcomes such as a decrease in readmissions, increase in patient satisfaction and efficiency in appropriate treatment.

Method A scoping review to analyze data by grouping articles into themes which included authors, date of publication, aims/purpose, methodology, sample, interventional details, and the key findings in each article. Excluded articles included those discussing COVID-19 and case management. …

Impact Of Ante- And Postnatal Depression Screening In Women With Hiv: A Scoping Review, Kimberly M. Grider Bsn, Rn, Pmh-Bc, Bao Chau Le Bsn, Rn, Blessing Okon Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Maternal depression has been identified as a strong predictor of poor prenatal care. Among pregnant women living with Human Immunodeficiency Virus (HIV), mental health-related factors such as depression could potentially undermine effective antiretroviral therapy (ART) adherence, increase mortality, and cause poor HIV viral suppression consequently impacting vertical transmission of HIV. This scoping review aims to identify existing knowledge regarding the impact of ante- and postnatal depression screening in women with HIV and to adduce the necessity for effective screening.

Methods A literature search was performed for studies with primary outcomes of depression screening within the context of ante- or …

Sleep Deprivation And Delirium Development In The Icu, Cynthia Howell Msn Fnp-Bc, Stacy Murillo Msn Fnp-Bc, Amy Wilson Msn Fnp-Bc, Tracy Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Delirium is an acute syndrome characterized by disturbances in cognition occurring in critically ill patients, particularly those over 65 in the intensive care unit (ICU). Numerous risk factors are associated with delirium development, with sleep being a modifiable factor. This review explores existing literature regarding the relationship between sleep deprivation and delirium development while evaluating the effectiveness of a sleep promotion protocol to decrease the incident of delirium in those ICU patients 65 years or older.

Method A literature review of peer-reviewed studies from PubMed and additional search engines was completed. Articles reviewed were published within the last five …

Behavioral Code Team, Daniel Mcgrath

Student Scholarly Projects

Practice Problem: The organization lacked an evidence-based intervention for behavioral emergencies within the inpatient acute care setting, leading to increased mechanical restraints. A security-driven paradigm was the organization's primary tool for addressing behavioral crises and lacked a more patient-centered treatment and support paradigm.

PICOT: The PICOT question that guided this project was In the Veteran patient population admitted to acute inpatient services (P), how does having a behavioral code team respond to behavioral emergencies (I) compared to the current practice (C) affect the prevalence of mechanical restraint usage (O) within an eight week period (T).

Evidence: Seven …

The Impact Of Student Trauma: A Quantitative Investigation On Secondary Traumatic Stress And It's Effects On Nursing Faculty, Devon L. Luthens

Education Doctorate Dissertations

The increase in student trauma and mental illness is putting direct care professionals such as educators at risk of secondary traumatic stress. The purpose of this quantitative survey method research was to explore how nursing faculty within the Minnesota State system were affected by their work with traumatized students and if they experienced significant distress or impairment. The theoretical framework guiding this dissertation was the McCann and Pearlman’s Constructivist Self Development (CSD) theory. There were two research questions that led this study: Does the amount of exposure to student trauma relate to the level of secondary traumatic stress experienced by …