Psychiatric and Mental Health Nursing Commons^™

Implementation Of A Community Health Worker (Chw) Training Program To Improve Birth Outcomes, Emiko Maruri

Doctor of Nursing Practice (DNP) Projects

Background

Those who have been affected by any adverse childhood experience (ACE) have an increased likelihood of poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss.

Problem

Latina women have been identified by the Centers for Disease Control (CDC) as those most affected by ACEs. Further evidence supports those affected by 2 or more ACEs have poor birth outcomes.

Context

For this project, The Save the Children organization in partnership with the University of San Francisco Doctorate of Nursing Practice (USF DNP) students and Community Health Workers (CHWs) of the Central …

Implementation Of Fast-Track Triage Process To Improve Ambulance Patient Offloading Time (Apot) In A Psychiatric Emergency Services (Pes) Unit, Oke Augustine Umeugoji

Doctor of Nursing Practice (DNP) Projects

Abstract.

Background.

Ambulance delays in hospital EDs have recently been significant in the United States. This delay has been attributed to emergency department overcrowding, a record number of 911 calls, a shortage of ED staff (doctors and nurses), and poor resources available in the communities as alternatives to an ED visit. Local Emergency Medical Service Authorities (LEMSA) monitor and determine the community standards for measuring ambulance offload delays (AOD), usually in minutes.

Problem.

Lengthy ambulance patient offload times and their subsequent impact on EMS have been significant all around the state of California as well as nationwide. The ambulance delay …

Depression Screening Tool For Hysterectomy Patients, Dede C. Mihedji

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The prevalence of hysterectomies in the United States ranges from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing

depression preoperatively could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy.

Local Problem: Currently, there is no standard of practice to routinely screen for depression in preoperative patients scheduled for hysterectomy surgeries. However, as with any surgical intervention, there are risks of long-term complications. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). …

Enhancing Mental Health Assessments For Hysterectomy Patients: Implementing A Depression Screening Tool For Healthcare Clinicians, Dede Mihedji

Doctor of Nursing Practice (DNP) Projects

Background: Hysterectomies are prevalent in the United States ranging from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing preoperative depression could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy. Local Problem: Currently, there is no standard practice for preoperative depression screening in hysterectomy patients. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). Methods: To address the gap, clinicians attended a fifteen-minute Zoom course on the Patient Health Questionnaire 9 (PHQ-9) and its …

Promoting Parent-Child Relationships Through Community-Based Family Wellness Programs To Improve Mental Health In Children, Maria Elena Falcon

Doctor of Nursing Practice (DNP) Projects

Objective: Adverse childhood experiences can affect a child mentally and lead to mental, health, and learning problems later in life. Establishing healthy parent-child relationships through family-oriented programs can promote mental well-being, improve behavior and learning in children and strengthen positive parent-child relationships.

Methods: A systematic electronic search using databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and PsycINFO, contextualized current research on the importance of parent-child relationships and their influence on mental health. The inclusion criteria for the review used were articles in the English language and relevant dates from 2014 to 2021. The key terms used …

Reconceptualizing Complex Post-Traumatic Stress Disorder: An Evolutionary Concept Analysis And Clinical Guide, Jessica Livingston

Doctoral Projects

Conflicting models of how trauma manifests into identifiable symptoms have been a source of controversy and perplexity among practicing mental health clinicians and diagnosticians. Complex post-traumatic stress disorder (CPTSD) is now an internationally recognized diagnosis since its inclusion in the 11^th version of the World Health Organization’s (WHO) International Classification of Diseases (ICD-11) in 2018. The American Psychological Association (APA) does not share this recognition of CPTSD as an individual diagnosis and instead opted to update the diagnostic criteria for PTSD to include DSO and a 4^th category of dissociative features rather than include CPTSD as a separate …

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …

Scaffolded Simulation In Psychiatric Mental Health Nursing Education, Lori Bobo, Stacy Mikel, Yolanda Chandler, Hungwei Tseng

Higher Learning Research Communications

Objectives: The purpose of this study was to investigate the impacts of using scaffolded clinical simulations on nursing students’ confidence in clinical reasoning, clinical judgment, and critical thinking skills. Next, we also attempted to gain insights into students’ perceptions of the benefits of scaffolded clinical simulations.

Method: We used a mixed-methods research design to investigate the impacts of using scaffolded clinical simulations on 133 second-semester baccalaureate nursing students’ confidence in clinical reasoning, clinical judgment, and critical thinking skills.

Results: Findings from this study indicate that students who perceived the benefits of scaffolded simulation activities (i.e., peer observations, debriefings, and self-reflections) …

The Effects Of Non-Pharmacological Interventions For Behavior And Psychological Symptoms Of Dementia: A Benchmark Study, Rachel R. Williams

MSN Capstone Projects

The management of behavioral and psychological symptoms of dementia (BPSD) in patients who reside in nursing homes can be challenging. These neuropsychiatric behaviors can include but are not limited to aggression, agitation, delirium, depression, and psychosis (Cloak & Al Khalili, 2022). Patients with BPSD often have difficulty expressing their needs due to the disease process, resulting in further complexity when managing behaviors. There are no psychotropic medications to treat BPSD specifically, but many are often prescribed to treat the symptoms or behaviors exhibited by patients. The use of psychotropics, especially long-term can cause a myriad of adverse effects and should …

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 …