Psychiatric and Mental Health Nursing Commons^™

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

Dissertations

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

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

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

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

Brain and Mind Institute

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

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

Senior Theses

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

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

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

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

Internal Medicine, East Africa

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

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

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

Doctor of Nursing Practice Final Project Abstract

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

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

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

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

DNP Qualifying Manuscripts

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

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

Dissertations

Abstract

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

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

Screening For Depression Post Acute Coronary Syndrome, Alyssa Graham

Dissertations

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

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

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

Doctor of Nursing Practice Final Manuscripts

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

By

Abbie Kim Bates

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

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

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

Master's Projects and Capstones

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

This quality improvement project implemented …

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

Electronic Theses and Dissertations

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

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

Dissertations

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

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

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

Journal of Social, Behavioral, and Health Sciences

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

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

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

Results: …

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

Dissertations

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

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

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

Dissertations

Abstract

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

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

Improving Mental Health Outcomes For Amputees, Zachary Elmore

Dissertations

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

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

Restraint Reduction Using The Brøset Violence Checklist, Deanna Kappelmann

Dissertations

Abstract

Problem: Patient aggression, restraint usage and assaults against healthcare workers have numerous negative health outcomes. Patient aggression and restraint usage on inpatient psychiatric units can be identified early with imminent violence predicative tools such as the Brøset Violence Checklist (BVC), where patient de-escalation interventions can subsequently occur.

Methods: This quality improvement project was conducted using a cohort design with a retrospective and prospective chart review. The IHI PDSA model was used for this project. The BVC was administered to male and female patients ages 18 to 64 years old on the adult inpatient psychiatric unit during the implementation period. …

Implementing A Brief Intervention For Smoking Cessation In An Inpatient Psychiatric Facility, Erika Gotway

Dissertations

Abstract

Problem: Smoking is a leading cause of various preventable diseases, and those who experience mental illness smoke cigarettes at a higher rate than the general population. Brief intervention is a type counseling that has proven successful in encouraging smokers to quit. The “5 A’s” is a type of brief intervention which stands for: Ask, Advise, Assess, Assist, Arrange. Addressing the smoking epidemic among individuals with mental illness is not only essential for improving their overall well-being, but also for reducing health disparities and enhancing the effectiveness of existing mental health interventions.

Methods: The approach to this project was a …

Evaluation Of The Grief Of Mothers Affected By Perinatal And Traumatic Loss, Landry Crabtree

Dissertations

Problem: The experience of a perinatal loss can be traumatic for mothers, and complicated grief reactions are common for those who have experienced a perinatal loss. An increase in perinatal loss resources is needed in the United States. The purpose of this program evaluation was to assess outcomes of a pilot perinatal loss support program on the grief of women who have experienced a perinatal loss.

Methods: This project was an evaluation of a perinatal loss support program that employed evidence-based strategies in both individual and group therapy sessions. A retrospective design was used, and data on perinatal …

Reducing Stress And Improving Mindfulness Practices Among Mental Health Professionals Through Guided Meditation., Liara G. Patton

Doctor of Nursing Practice Papers

Abstract

Background: Chronic exposure to psychological stress places mental health providers in a vulnerable position when coping skills are not learned or available. Mental health providers are at risk for both mental and physical illness due to the empathetic demands of their client’s stressors. The deficit in adequate coping skills can cause provider-client relationships to suffer and create an undesirable work environment.

Setting: This project took place in Somerset, KY, at a mental health company called A New Beginnings Achievement Center (ANBAC). Twenty-six employees work at ANBAC, all of whom are involved in providing mental health services to developmentally delayed …