Psychiatric and Mental Health Nursing Commons^™

Improving Postpartum Depression Screening And Treatment Referral Rates In An Ob-Gyn Clinic, Ciddet Abrahams

Doctor of Nursing Practice

Abstract

Background: Up to 25 % of adult women are diagnosed with postpartum depression. This diagnosis may also lead to poor health outcomes for the mother and the infant. Four out of five women with a positive screening for postpartum depression do not receive care from a mental health provider.

Purpose: The purpose of the project was to improve postpartum depression screening and follow-up care to mental health services in a clinic providing obstetrical and gynecological care in the central Texas area.

Objectives: The primary objective of the project was to increase postpartum depression screening rates. The second objective was …

Depression Screening At A Mental Health Outpatient Clinic: A Quality Improvement Project, Renee Licorish

Doctor of Nursing Practice

Project Background: Depression is one of the most common mental health problems in the United States. Many individuals may seek treatment but go undiagnosed due to the lack of recognition by clinicians. Clinical guidelines recommend the use of a standardized depression screening tool within a clinician’s evaluation process. The Patient Health Questionnaire 9 (PHQ-9) is such a tool and recommended for use in the outpatient care setting. Aims of the Project: To increase depression screening of clients at a hospital-based outpatient behavioral health clinic. Purpose and Objectives: Implementation of the PHQ-9 into the clinic’s mental health assessment process to increase …

A Quality Improvement Initiative To Implement The Geriatric Depression Scale In A Geriatric Inpatient Psychiatric Unit, Candice Hall

Doctor of Nursing Practice

The World Health Organization (2017) estimated that over 300 million people worldwide have depression. According to the Centers for Disease Control and Prevention (2013), 7 million Americans over 65 years old experience depression annually. The United States Preventive Health Services Task Force recommends the use of a depression screening tool in the adult population. The purpose of this evidence-based quality improvement project was to improve screening for depression in an inpatient geriatric psychiatric unit. The primary objectives included educating nursing staff on depression screening and using the geriatric depression scale (GDS) to assess patient's level of depression at admission and …

Quality Improvement On Depression Protocols In The Military Training Environment, Priscilla R. Colunga

Doctor of Nursing Practice

Background: Active Duty military members are highly susceptible to depression and suicide due to separation from family during training and deployments, exposure to traumatic experiences in combat, and loss of friends during combat.

Purpose and Objectives: Depression and suicide remain a high priority among military personnel. This process improvement project aimed to improve the rate of depression screening and improve the assessment, treatment, and management of soldiers with depression in a primary care setting to prevent disease progression while waiting to be seen by a behavior health specialist.

Interventions: During the 6-week time frame, all active duty military and reservists …

Evaluation Of Short Term Cognitive Behavioral Therapy Intervention In A Primary Care Setting, Kevin Hengeveld

Doctoral Projects

Introduction: Depression and anxiety are chronic recurring medical conditions that impact all aspects of health. When depression and anxiety are present with other comorbid diseases, mortality and health care costs are higher. Children and young adults are particularly vulnerable to mental health issues. Suicide is the 2nd leading cause of death for this demographic. Depression is common in adolescents with an incidence of 8 to 20 percent. Primary care provides 70 percent of mental health care in the United States, and the primary intervention offered is pharmacological. Evidence suggests that a combination of medication and psychotherapy provide superior relief of …

Recommended Interventions To Address The Education-Practice Gap In Mental Health Nursing: An Integrated Literature Review, Marlena D'Agostin

Grace Peterson Nursing Research Colloquium

Abstract

Background: Mental health is all encompassing and is widely prevalent in the U.S. population, demonstrating a need for effective care for patients in the mental health setting. There is a gap, however, in providing the highest quality of care within this setting named the theory-practice gap. The theory-practice gap creates a barrier in translating knowledge that is being taught in the classroom to what is used in clinical practice.

Objectives: The purpose of this integrative literature review was to investigate the theory-practice gap in mental health nursing through the implementation of evidence-based practice (EBP) in the clinical practice setting …

Common Components Of Fetal Alcohol Spectrum Disorder Prevention Intervention Programs: A Review Of Literature, Ross Siemering

Grace Peterson Nursing Research Colloquium

Abstract

Background: Fetal alcohol spectrum disorders (FASD) are the most common yet completely preventable cause of mental disability in the western world.

Objective: The purpose of this integrative literature review is to examine and identify the common elements among varying interventions for FASD prevention that have demonstrated effectiveness for reducing the risk of FASD to better understand what defining features may contribute to the efficacy of the interventions.

Methods: An integrative literature review was conducted. The databases searched included: CINAHL, PubMed, Cochrane Library, and Science Direct. Articles were then reviewed to determine if they were appropriate for inclusion based upon …

Barriers To Providing Psychiatric Care Within Cook County Public Health System: An Integrative Literature Review, Elizabeth Ann Reuter

Grace Peterson Nursing Research Colloquium

Abstract

Background: Cook County Public Health Systems located in Cook County, Illinois, are responsible for providing free and low cost psychiatric care to thousands of residents despite continuing state and federal budget cuts and inadequate Medicaid reimbursements. This not only financially strains county taxpayers, but it also limits treatment options, negatively impacts patients, and places an extreme burden on the public service workforce.

Objectives: The purpose of this integrative literature review was to identify the major barriers of providing psychiatric care within Cook County Public Health Systems.

Method: An integrative literature review was conductedusing the databases of Academic Search …

Nurses Role In Health Home Mixed Methods Study, Jacqueline S. Prokop

Nursing Theses and Dissertations

Managing individuals with chronic health conditions in the primary care setting continues to be a significant challenge in the U.S. health care system. This issue is further compounded for low-income individuals with both mental health and physical health chronic conditions. With the enactment of the Affordable Care Act (ACA), new chronic disease health home opportunities have emerged to address the existing structural and process gaps found in primary healthcare. The nurse’s role is integral to health homes as they empower nurses to play a greater role in improving patient experiences, population health, and lowering healthcare costs. Three research manuscripts presented …

Failure-To-Rescue Simulations As A Risk Management Strategy For Registered Nurses, Trena K. Seago

Graduate Theses, Dissertations, and Capstones

In the hospital setting, prevention of failure-to-rescue (FTR) events is an important aspect of patient safety. The use of patient simulation as a strategy to educate nurses on the prevention of these events offers two modes of learning: 1) experiential learning through simulation and 2) reflection through debriefing. The act of practicing to recognize a deteriorating patient through experiential learning and reflection may help increase nurses’ self-efficacy in recognizing a similar situation in their future practice. This quasi-experimental, one-group, pretest-posttest pilot study investigated the use of patient simulation among registered nurses (RNs) in the hospital setting as an anticipatory educational …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Care For Inmates With Mental Illness: What Can Nurses Do?, Rebecca K. Sakai

Honors Projects

This paper serves to inform nurses of the medical and psychiatric treatment that inmates with mental illness receive and to offer suggestions for treatment interventions. Current practice includes mental health screens, psychotropic medication administration, psychiatric departments, and administrative segregation. The recommended interventions include providing therapy (including Cognitive Behavioral Therapy and Group Therapy), decreasing administrative segregation, implementing reintegration programs, and training and collaborating with correctional officers.

A Common Goal: Primary Care And Psychiatry Improve Depression Detection And Outcomes, Katherine Kilkenny

Doctor of Nursing Practice Final Manuscripts

Background: Major Depressive Disorder (MDD) affects over 15 million (6.7%) adult Americans. While one in four primary care patients suffer from depressive symptoms, MDD is accurately diagnosed as little as 25% of the time.

Purpose: Implementation of an evidence-based protocol outlining the process for screening, behavioral health referral, and the role of a collaborative care team would improve detection and treatment of adult MDD patients in the ambulatory setting.

Process: A systematic Patient Health Questionnaire (PHQ-9) based screening protocol was implemented. Every new and existing patient completed the PHQ-9 during scheduled primary care appointments. If a patient scored 15 or …

Family Nurse Practitioner Student Competencies In Integrated Psychiatric Healthcare, Mark Manning

Doctor of Nursing Practice Final Manuscripts

Title: Practicum to Practice: Family Nurse Practitioner Student Competencies in Integrated Psychiatric Mental Healthcare.

Background: Major Depressive Disorder (MDD) is a widespread and costly diagnosis that affects nearly 16 million people annually and costs the United States nearly $83 Billion. Primary care providers such as Family Nurse Practitioners (FNP) play a crucial role in screening for health problems, preventing, and managing illness. Opportunities exist to integrate psychiatric mental healthcare into FNP curriculum and clinical practicums to better prepare providers to identify and screen for depression.

Purpose: The purpose of this evidenced-based practice project is to evaluate FNP student competencies …

Metabolic Syndrome Screening Among Inpatient Psychiatric Patients, Susan Magorno

Doctor of Nursing Practice Final Manuscripts

Background: More than 50% of patients with severe mental illness carry undiagnosed Metabolic Syndrome (MetS) comorbidities of hypertension, hyperlipidemia, or diabetes. These patients are three times more likely to die of cardiovascular-related causes; however, this population is not routinely assessed for MetS and frequently lack appropriate treatment.

Objective: The objective is to implement a screening tool designed to identify risk for MetS and trigger appropriate treatment.

Design: The screening tool triggers the provider to address positive criteria through interventions such as further evaluation, medical and/or diabetes educator consultation.

Results: Although overall rates of screening improved significantly, follow-up interventions were …

Using An Educational Session To Improve The Knowledge, Confidence, And Beliefs About Psychopharmacology For Behavioral Health Clinicians, Sharon Bennett

Doctor of Nursing Practice Projects

Background: Psychiatric illness is unpredictable, has spasmodic tendencies, and represents one of the most reported types of disabilities in the United States. Behavioral health clinicians are front line respondents and considered a major ally to providers by supporting medication management recommendations and referring new patients for medication management. Basic evidence-based psychopharmacology improves behavioral health clinicians’ knowledge, however, is inadequate in curricula, and many undergraduate and graduate programs lack one dedicated psychopharmacology class. This abbreviated knowledge contributes to inadequate referrals for treatment and poor confidence in supporting the practitioners’ medication recommendations.

Method: This project examined behavioral health clinicians’ knowledge, confidence, and …

Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller

Master's Theses

This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …

Nature's Effect On Mental Health, Hannah Thomas

Senior Honors Projects, 2010-2019

The United States has an overwhelming number of people suffering from mental illness, especially anxiety and depression. These disorders can be debilitating in many areas of the person’s life. Not even half of those diagnosed with these conditions are treated effectively and costs are expected to rise significantly in the coming years. One population that is often overlooked that suffers from these conditions is health professionals themselves. Physicians and nurses have high rates of depression and anxiety due to the stress from their occupation. In order for more patients and providers to be treated and for the health care system …

Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott

Doctor of Nursing Practice Scholarly Projects

The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …

School Nurses' Knowledge And Perceived Role In Mental Health Issues, Kayla Bakker

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background:

There are 74.5 million children in the United States, 17.1 million currently or have previously dealt with a mental disorder (Children’s Mental Health, 2015). Unfortunately, the negative stigma associated with mental health often causes those affected to not seek treatment. School nurses are on the front line of public health problems and deliver safe, effective evidence-based practice to their communities. To rebuild our broken mental health system, community nurses need to build upon school mental health services and encourage more in-school programs (Stephan, Weist, Kataoka, Adelsheim, & Mills, 2007). School nurses must be included in the discussion when …