Psychiatric and Mental Health Nursing Commons^™

Behavioral Health Patients And Agitation In The Emergency Department: A Synthesis Of Literature, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Abstract

Introduction: Patient agitation is a phenomenon that presents itself to the emergency department (ED) on a daily basis. Agitation can manifest from an array of physical or psychological complaints. Behavioral health patients presenting with agitation is a growing subset of the total agitation population within EDs. A better understanding of behavioral health patient agitation in the ED setting is needed to guide best practices in treating this fragile population with therapeutic, patient-centered care.

Methods: A review of literature was conducted on agitation and behavioral health in ED settings, using the search terms emergency department, agitation, restraints, sedation, and behavioral …

Psychological Distress During The Covid-19 Pandemic In Nursing Students: A Mixed Methods Study, Mayantoinette Watson

Dissertations

During such an unprecedented time of the largest public health crisis, the COVID-19 pandemic, nursing students are of the utmost concern regarding their psychological and physical well-being. Questions are emerging and circulating about what will happen to the nursing students and the long-term effects of the pandemic, especially now that hospitals are being overwhelmed with COVID-19 cases and patients as well as a significant need for nursing staff (Jividen, 2020). Expectations, demands, change, and the fear of the unknown during this unprecedented time can only contribute to the many stressors that accompany nursing students through laborious clinical and didactic courses …

A Performance Improvement Project To Improve Hand-Off Communication Documentation Within The Surgical Services Department, Bobbie J. Wich, Millie Escalona, Judy E. Bowling, Ana L. Santos

Nursing & Health Sciences Research Journal

Over 80% of adverse events in healthcare are due to miscommunication. To improve patient safety, The Joint Commission recommended the use of standardized hand-off communication tools in 2012. One acute care hospital in Southeast Florida implemented standardized handoff reports in 2014 with few revisions since that time. The COVID-19 pandemic brought to light additional critical information was needed to keep patients and staff safe, such as laboratory results indicating the need for isolation precautions. The nurses within the surgical services noticed this critical information was not sufficiently included in the handoff report. The lack of this information led to unnecessary …

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the treatment …

Change Project Using A Fall Prevention Action Program To Decrease Falls On A Behavioral Health Unit, Amy Shuptrine

Student Scholarly Projects

Practice Problem: Fall rates are increasing in the behavioral health units of the East Texas hospital. Due to the worldwide COVID-19 pandemic, the units are short-staffed, which further supports the urgent need for a targeted intervention to reduce fall risk.

PICOT: The PICOT question that guided this project was: “In adult behavioral health patients (P), what is the effect of the Edmonson Psychiatric Fall Risk Assessment Tool (I), compared with previous use of the Morse Fall Risk tool (C), on the fall rate (O), in 8 weeks (T)?”

Evidence: Falls are the most reported incidents in acute care hospitals and …

Depression Screening Upon Admission At An Addiction Facility: A Quality Improvement Project, Eric Aniekwena

Doctor of Nursing Practice

More than one in six Americans will have a diagnosis of a substance use disorder at some time in their life. According to the National Institute on Drug Abuse (2020), those with a substance use disorder will have an increased rate of having a comorbidity of depression or depression symptoms during treatment, leading to poorer outcomes. The purpose of this quality improvement project was to increase provider and staff adherence to the treatment standards outlined in the Veteran’s Affair/Department of Defense Clinical Practice Guideline for the Management of Major Depressive Disorder (Veteran’s Affairs/Department of Defense, 2016). During this 10-week process, …

Providing Resources To Caregivers Of Pediatric Mentally Ill Clients And Assessing For Caregiver Burden, Stacy Dee

Doctor of Nursing Practice

Background. Provision of educational and supportive resources to the caregivers of children with mental illness can help create an environment of advocacy and understanding between the child, caregiver, and provider. In depth and comprehensive learning about their child’s mental illness cannot be accomplished in a one-hour new patient appointment or established patient appointment of 20 minutes. Purpose. The purpose of this practice improvement project was to facilitate educational and community support for caregivers of pediatric clients with mental illness and evaluate if caregivers require additional support due to burden. Objectives. (a) 100% of caregivers of pediatric clients who have appointments …

Implementing Evidence-Based Treatment Of Patients With Opioid Use Disorder In An Inpatient Addiction Treatment Center, Emily Ashley

Doctor of Nursing Practice

Patients with opioid use disorder are at increased risk for overdose and death should they relapse due to reduced opioid tolerance after a period of abstinence. A retrospective chart review was performed at an inpatient drug and alcohol treatment center to identify areas in need of improvement. The global aim of this project was to promote patient adherence to treatment, as well as increase the prevention of patient overdose and death after inpatient treatment. Project objectives include improving provider management of opioid use disorder through standardizing patient education, increasing prescription of relapse prevention medication, initiating prescription of naloxone at discharge …

Implementation Of An Interprofessional Fall Prevention Program To Reduce Falls On An Older Adult Inpatient Psychiatric Unit, Teresa Woodson

Doctor of Nursing Practice

Background. Falls are the most reported incidents in the hospital setting, especially among older adults. According to the National Database of Nursing Quality Indicators (NDNQI), the number of falls in inpatient psychiatric units is 13-25 per 1,000 patient days, compared to 4 per 1,000 days for medical-surgical units. This DNP project aims to implement an interprofessional fall risk team to reduce falls in an older adult inpatient psychiatric unit. Problem. The psychiatric inpatient units had a total of 31 falls, with 13 (40%) occurring on the older adult unit. Interventions. Education of nursing staff, providers, and physical therapy (PT) …

Implementing An Evidence-Based Practice Change For Alcohol Withdrawal In An Acute Care Hospital, Theresa Carroll

Student Scholarly Projects

Practice Problem: Alcohol Use Disorders (AUD) affects a significant portion of the population in the United States. When AUD is either unrecognized or inadequately treated in the acute care setting it can lead to medical complications, increased length or stay (LOS), increased healthcare expense, and increased patient mortality.

PICOT: In a population of adult patients admitted to an acute care hospital progressive care unit (P), how does applying an initial evidence-based screening tool to detect risk for moderate to severe alcohol withdrawal, the PAWSS (I), compare to no standard screening or assessment for potential alcohol withdrawal symptoms (C) affect the …

Medicated-Assisted Treatment And 12-Step Programs: Evaluating The Referral Process, Candace S. Brown, Chudney Williams, Ryan E. Stephens, Jacqueline Sharp, Bobby Bellflower, Martinus T. Zeeman

Doctor of Nursing Practice Projects

Purpose/Background Overdose deaths in the U.S. from opioids have dramatically increased since the COVID-19 pandemic. Although medicated-assisted treatment (MAT) programs are widely available for sufferers of opiate addiction, many drop out of treatment prematurely. Twelve-step programs are considered a valuable part of treatment, but few studies have examined the effect of combining these approaches. We aimed to compare abstinence rates among patients receiving MAT who were referred to 12-step programs to those only receiving MAT.

Methods In this prospective study, a cohort of participants from a MAT clinic agreeing to attend a 12-step program was compared to 15 controls selected …

The Impact Of A 12-Hour Shift Compared To An 8-Hour Shift On Nurse Health And Safety, Matthew Kramer, Andrea Howell, Kayla Kloes, Emmy Lam, Brittney Levy

Symposium of Student Scholars

Abstract

Background: An international healthcare concern is extensive shift length among registered nurses and the negative factors associated with nurse burnout. Cognitive impairment, medical errors, sleep deprivation, job dissatisfaction, and overall declined health and safety of nurses have been associated to long shift work hours among registered nurses globally. However, there is limited published evidence about the difference between 8-hour and 12-hour shift work.

Objective: This systematic review summarized evidence on the impact that 12-hour shifts compared to 8-hour shifts has on the health and safety of registered nurses.

Methods: PubMed, SCOPUS, EBSCOHost, NCBI, Google Scholar, and …

Loneliness, Social Isolation, And Their Connection To Overall Health Across The Lifespan, Paige Miller

Senior Honors Theses

Due to recent circumstances, the incidence of loneliness and social isolation has skyrocketed. Fortunately, there have already been countless studies examining the longer-term implications of these two factors on health. Loneliness and social isolation have been found to impact cardiovascular health, stress response, immune function, resilience, mental health, attachment, spiritual health, and many other determinants of health. A variety of research was examined outlining the psychological implications of loneliness and social isolation. These factors also influence physiological processes and can exacerbate a variety of diseases. After presentation of this evidence, a collection of possible interventions will be discussed, and their …

Reducing The Potential For Physical Harm In Student Nurses Caring For Clients Who Are Under The Influence, Hunter William Halford

Electronic Theses and Dissertations

This DNP project was conducted to identify gaps in knowledge and adequate preparation of nursing students in safely caring for a client who is behaving violently and is under the influence of illicit drugs. Student nurses are trained using a generalist approach, meaning they are taught the essentials of a variety of topics. It is not until these students enter the workforce that they are trained specifically for a certain position. Currently, the curriculum does not address specific measures to maintain client and personal safety. It is an almost unavoidable fact that a nurse will encounter a violent client or …

Breaking Down The Impact Of Resilience On Mental Health: An Analysis Utilizing The Resilience Scale For Adults, Sydney K. Cook

The Journal of Purdue Undergraduate Research

Resilience is the capacity to recover quickly from difficulties, and previous studies have determined that resilience has a relationship with mental health. However, the association of each aspect of resilience on mental health, depression, and adverse childhood events (ACEs) have not been closely examined. Discerning which aspects of resilience are associated with mental health issues, depression, and ACEs can help psychiatric nurses determine effective treatments and interventions for at-risk patients.

One hundred ninety-five community-dwelling participants (ages 18 to 89) were invited to Purdue University in Indiana and Scripps College in California for the study. Participants completed the Resilience Scale for …

Benzodiazepine Reduction Program In A Psychiatric Mental Health Setting, Tracy Pacini

Dissertations

Benzodiazepine Reduction Program in a Psychiatric Mental Health Setting

The purpose of this pilot project was to reduce side effects and adverse effects of long-term benzodiazepines (BZDs) use in a non-profit community health center. This was a quality improvement project. The evidence-based practice (EBP) framework identified for the project was from the Institute for Healthcare Improvement (IHI) Plan-Do-Study-Act (PDSA) framework to decrease BZD use in a non-profit community health center. This model is focused on four stages: 1) gathering a proactive healthcare team to examine and identify solutions to reduce BZD usage, 2) testing the pilot program that the team …

Social Anxiety Screening And Associated Factors Among University Students, Kathleen Prendergast

Seton Hall University Dissertations and Theses (ETDs)

Social anxiety is a type of anxiety triggered by social situations whereby the individual feels scrutinized by others, and which may contribute to avoidance of certain situations. This avoidance can interfere with personal, academic, and career endeavors. Cognitive behavioral therapy can help manage social anxiety. However, social anxiety is often underrecognized and
under treated. A survey with the Liebowitz Social Anxiety Scale (LSAS) was disseminated to identify and address this need among students in a large Northeastern university in the United States. The study is valuable as a pilot study. There was a small response rate for participation in the …

Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C

Doctor of Nursing Practice Projects

Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.

Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …

Shu Altop News Issue #4, Fall, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

Updates from the Davis & Henley College of Nursing Sacred Heart University Alternatives to Opioids for Pain Grant.

Alternatives to Opioids for Pain (ALTOP) is a HRSA funded project to help combat the opioid epidemic in Connecticut.

In this issue: • New Roles in Our Team • ANEW HRSA 2021-2022 Awardees • Southwest Community Health Center Chiropractic Care Services • Student Quality Improvement Project • Sacred Heart University Alumni Working at New Solutions Pain Management Clinic.

The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook

Electronic Theses and Dissertations

Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …