Mental and Social Health Commons^™

Adverse Events In Veterans Affairs Inpatient Psychiatric Units: Staff Perspectives On Contributing And Protective Factors., Gala True, Rosemary Frasso, Sara W. Cullen, Richard C. Hermann, Steven C. Marcus

College of Population Health Faculty Papers

OBJECTIVES: This study sought to identify risk factors and protective factors in hospital-based mental health settings in the Veterans Health Administration (VHA), with the goal of informing interventions to improve care of persons with serious mental illness.

METHODS: Twenty key informants from a stratified sample of 7 VHA inpatient psychiatric units were interviewed to gain their insights on causes of patient safety events and the factors that constrain or facilitate patient safety efforts.

RESULTS: Respondents identified threats to patient safety at the system-, provider-, and patient-levels. Protective factors that, when in place, made patient safety events less likely to occur …

Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons, Amanda Fallin-Bennett, Nadra E. Lisha, Pamela M. Ling

Nursing Faculty Publications

Introduction—Lesbian, gay, and bisexual (LGB) individuals smoke at rates 1.5–2 times higher than the general population, but less is known about LGB consumption of other tobacco products (OTPs) and gender differences. OTP use among young adult LGB bar patrons and the relationship among past quit attempts, intention to quit, and binge drinking with OTP use was examined.

Methods—A cross-sectional survey of young adults (aged 18–26) in bars/nightclubs in seven U.S. cities between 2012 and 2014 (N=8,010; 1,101 LGB participants) was analyzed in 2016. Logistic regressions examined current use of five OTPs (cigarillos, electronic cigarettes, hookah, chewing tobacco, and …

2484: Establishment Of The Tennessee-Sickle Cell Disease Network As A Mechanism For Engaging A Rare Disease Population In Patient Centered Outcomes Research, Tilicia Mayo-Gamble, Velma Mcbride Murry, Michael R. Debaun

Health Policy & Community Health: Faculty Publications

OBJECTIVES/SPECIFIC AIMS: Despite the high prevalence of individuals diagnosed with sickle cell disease (SCD) in Tennessee, comprehensive care and education for patients with SCD is not as widely available as healthcare services for individuals managing other chronic illnesses. We aimed to engage SCD stakeholders in patient-centered outcomes research (PCOR) as a mechanism for advancing care and translational research for this rare disease population. METHODS/STUDY POPULATION: Through a partnership with the Sickle Cell Foundation of Tennessee, we implemented Community Health Ambassadors to systematically engage patient partners with SCD and their caregivers, aged 18–50 from rural and urban communities throughout Tennessee, in …

Analyzing The Effectiviness Of A Prescription Drug Monitoring Program Targeting At-Risk Opioid Abuse Patients, Treadway Childs

Public Administration ETDs

The effectiveness of a prescription drug monitoring program in coordination with a prescription opioid recidivism program was examined at a semi-rural community hospital. Patients were identified by a multi-disciplinary committee to be at-risk for opioid misuse or abuse, and were denied prescription opioids. Patients were considered eligible for the program if they had over 12 emergency department visits in the previous 12 months, or 6 visits in the previous 6 months, depending on how long the hospital had records on a patient. Patients who were placed in the prescription opioid recidivism program could not receive opioids at this hospital. The …

Attitudes Toward Antipsychotic Treatment Among Patients With Bipolar Disorders And Their Clinicians: A Systematic Review, Martha Sajatovic

Faculty Scholarship

Introduction: Antipsychotics are recommended as first-line therapy for acute mania and maintenance treatment of bipolar disorder; however, published literature suggests their real-world use remains limited. Understanding attitudes toward these medications may help identify barriers and inform personalized therapy. This literature review evaluated patient and clinician attitudes toward the use of antipsychotics for treating bipolar disorder. Materials and methods: A systematic search of the Cochrane Library, Ovid MEDLINE, Embase, and BIOSIS Previews identified English language articles published between January 1, 2000, and June 15, 2016, that reported attitudinal data from patients, health care professionals, or caregivers; treatment decision-making; or patient characteristics …

Barriers And Facilitators To The Integration Of Mental Health Services Into Primary Health Care: A Systematic Review Protocol., Edith K Wakida, Dickens Akena, Elialilia S Okello, Alison Kinengyere, Ronald Kamoga, Arnold Mindra, Celestino Obua, Zohray M Talib

Health Policy and Management Faculty Publications

Background

Mental health is an integral part of health and well-being and yet health systems have not adequately responded to the burden of mental disorders. Integrating mental health services into primary health care (PHC) is the most viable way of closing the treatment gap and ensuring that people get the mental health care they need. PHC was formally adapted by the World Health Organization (WHO), and they have since invested enormous amounts of resources across the globe to ensure that integration of mental health services into PHC works.

Methods

This review will use the SPIDER (Sample, Phenomenon of Interest, Design, …

The Effects Of Perinatal Oxycodone Exposure On Behavioral Outcome In A Rodent Model, Thitinart Sithisarn, Sandra J. Legan, Philip M. Westgate, Melinda E. Wilson, Kristen Wellmann, Henrietta S. Bada, Susan Barron

Pediatrics Faculty Publications

Opiate addiction is now a major public health problem. Perinatal insults and exposure to opiates such as morphine in utero are well known to affect development of the hypothalamic–pituitary–adrenal axis of the offspring adversely and are associated with a higher risk of developing neurobehavioral problems. Oxycodone is now one of the most frequently abused pain killers during pregnancy; however, limited data are available regarding whether and how perinatal oxycodone exposure (POE) alters neurobehavioral outcomes of the offspring. We demonstrated that exposure to 0.5 mg/kg/day oxycodone in utero was associated with hyperactivity in adult rats in an open field. No significant …

Long-Term Effectiveness Of The Question, Persuade, Refer (Qpr) Suicide Prevention Gatekeeper Training Program: Lessons From Missouri, Clay Litteken, Elizabeth Sale

Missouri Institute for Mental Health

Suicide in Missouri is a significant public health issue that has taken the lives of 8351 individuals over the last decade. The recognition of suicide as an imminent concern has led to the development of evidence-based prevention programs to decrease suicide-related mortality. One program, question, persuade, refer (QPR), has become the most widely-distributed gatekeeper training program in the world. This article presents both immediate and 2-year follow-up analyses of QPR trainees who work with youth, specifically examining changes in knowledge, self-efficacy, and help-giving behaviors. Results indicate both short- and long-term positive outcomes in knowledge and self-efficacy, supporting use of QPR.

“From The Edge Of The Abyss To The Foot Of The Rainbow – Narrating A Journey Of Mental Health Recovery” The Process Of A Wounded Researcher, Samantha J. Robertson, Diane Carpenter, Maggie Donovan-Hall

The Qualitative Report

In the UK, mental health service users are asked to “tell their stories” within clinical settings as a tool for diagnosis, formulation and treatment plans. Retelling, reliving and reflecting on traumatic and distressing experiences is not a benign activity. Yet the process of reframing lived experience within a personal narrative could support the development of: a more positive identity; self-management skills and improved social connections (Slade, 2009) and therefore contribute to mental health recovery. This is an exploration of my process as a wounded researcher in the development of a version of my narrative as an autoethnography. I developed a …

Evaluating Mental Health In Cuban Refugees: The Role Of The Refugee Health Screener-15, Rahel Bosson, Victoria A. Schlaudt, Monnica T. Williams, Ruth M. Carrico, Adriana Peña, Julio A. Ramirez, Jonathan Kanter

Journal of Refugee & Global Health

The Refugee Health Screener-15 (RHS-15) is widely used in refugee populations, but the psychometric properties and clinical utility have not been evaluated in Cuban refugees and entrants. The current study explored results from the Spanish version of the RHS-15 in a sample of 53 Cuban entrants and refugees, and of these, 17.6% screened positive for a mental health concern. Analyses suggested that a positive screening was significantly related to symptoms of anxiety, depression, and posttraumatic stress disorder; however, it was not associated with demographic variables such as gender, mode of transport, or the number of countries through which a refugee …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Clinicians’ Perspectives And Utilization Regarding Harm Reduction In Nursing Practice In Care Of Persons With Addiction: A Literature Review, Audrey Killarney

Grace Peterson Nursing Research Colloquium

Clinicians’ perspectives and utilization regarding harm reduction in nursing practice in care of persons with addiction: A literature review

Audrey Killarney, BS

Prof. Michelle Neuman, MSN, APN, RN

NSG 598: Graduate Research Synthesis

18 August 2017

Introduction

Background & Significance

Harm reduction is a concept best described as the recognition that individuals will engage in unhealthy behaviors, and the goal is to minimize the associated potential harm. (Stockwell, Reist, Macdonald, Benoit, & Jansson, 2010). Classically, it was used an alternative model of care for treating smokers and controlling the spread of HIV and hepatitis B (Henwood, Padgett, & Tiderington, 2014). …

The Benefits Of And Barriers To Psychiatric Advance Directive Implementation, Lauren Haindfield

Grace Peterson Nursing Research Colloquium

The Benefits of and Barriers to Psychiatric Advance Directive Implementation

Lauren Haindfield

Faculty Sponsor: Dr. Barbara Harris

Background: Psychiatric advance directives can be beneficial for patients with mental disorders, but their implementation is limited in large part due to a knowledge gap.

Objectives: The purpose of this integrative literature review was to identify both the benefits of and barriers to psychiatric advance directives.

Methods: This integrative literature review used the databases of CINAHL, PubMEd, and PsychInfo. Search terms included pad implementation, barriers to pad implementation, psychiatric advanced directives, benefits of psychiatric advanced directives, and current pad practices.

Results: PAD implementation …

Effective Methods For Domestic Violence Screening In The Emergency Department, Megan Bryan

Grace Peterson Nursing Research Colloquium

Abstract

Background: The CDC reports that one in four women and one in ten men will experience some form of domestic violence in their lifetime that will have either a short-term or long-term impact on their well-being. Often the first place these victims are seen where they can receive help is the emergency department. Objectives: The goal of this systematic integrative literature review was to explore existing literature on domestic violence screening methods used in the emergency department and determine which methods prove most effective. Concurrently, this review examined the barriers to effective domestic violence screening and how nursing education …

Barriers To Medication-Assisted Opioid Recovery: An Integrative Review Of Literature, Emily Miller

Grace Peterson Nursing Research Colloquium

Abstract

Background: Opioid addiction has become one of the fastest growing epidemics sweeping the world, but despite the use of opioid agonist medication-assisted treatment (MAT) with methadone or buprenorphine having been found to be one of the most effective methods for treatment of this epidemic, there is still a significant gap between the number of people that need MAT and the number of people that actually receive MAT.

Objective: The purpose of this integrative literature review is to explore the barriers that prevent many addicts from receiving MAT and to identify strategies that may assist in eliminating these barriers in …

An Update On The Opioid Epidemic: Perception Vs. Reality, Nicholas E. Hagemeier

ETSU Faculty Works

No abstract provided.

A Mixed Methods Study Of Hiv-Related Services In Buprenorphine Treatment, Hannah K. Knudsen, Jennifer Cook, Michelle R. Lofwall, Sharon L. Walsh, Jamie L. Studts, Jennifer R. Havens

Behavioral Science Faculty Publications

Background: Opioid use disorder (OUD) is a major risk factor in the acquisition and transmission of HIV. Clinical practice guidelines call for the integration of HIV services in OUD treatment. This mixed methods study describes the integration of HIV services in buprenorphine treatment and examines whether HIV services vary by prescribers’ medical specialty and across practice settings.

Methods: Data were obtained via qualitative interviews with buprenorphine experts (n = 21) and mailed surveys from US buprenorphine prescribers (n = 1174). Survey measures asked about screening for HIV risk behaviors at intake, offering HIV education, recommending all new patients …

On-The-Spot Mindfulness Based Practices For Addressing Behavior Challenges Among 3rd Graders, Christina Francis

Master's Projects and Capstones

Purpose: The purpose of this project was to introduce and implement a mindfulness based tool that will empower students to manage their stress which contributes to their classroom behavior and allow teachers to minimize the amount of classroom time spent addressing behavior challenges.

Methods: Observations of third grade classrooms, key informant interviews with third grade teachers and community observations were conducted at the Achieve Academy School while throughout the school day.

Results: Findings showed that students would benefit from the implementation of On-The-Spot Mindfulness Based Techniques and Practices by minimizing stress, increasing academic success and improving the overall behavior, …

Mindful Classroom: Developing And Testing Strategies For Resilience Among Urban 7th Grade Students, Alyssa Santos

Master's Projects and Capstones

Introduction: A growing body of research suggests mindfulness-based classroom interventions are an effective, low cost approach to reducing the effects of toxic stress among youth. The purpose of this project was to identify key sources of stress among urban 7th grade students at De Marillac Academy and develop and test mindfulness techniques to actively engage and potentially improve stress management skills among students.

Methods: Five focus groups with students were conducted to assess the most prominent sources of stress inside and outside of school as well as current self-management strategies. Additionally, anonymous online surveys were distributed to 7th grade parents, …