Psychiatric and Mental Health Nursing Commons^™

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 …

Adverse Psychological Effects Of Patients In Medical Isolation Due To Healthcare-Associated Infections, Kristin Brill

Grace Peterson Nursing Research Colloquium

Background: Patients placed in medical isolation due to healthcare-associated infections experience adverse psychological effects that can impact their quality of life.

Objectives: The purpose of this integrative literature review was to identify the adverse effects of patients in medical isolation as well as explore coping strategies that can be used to decrease these adverse effects.

Method: An integrative literature review was conducted using the databases of CINAHL, PsychInfo, PubMed, and PsychArticles. Search terms included adverse effects, negative effects, effects, adverse outcomes, negative outcomes, isolation precautions, contact isolation, droplet isolation, airborne isolation, isolation, coping and psychology.

Results: Five common adverse psychological …

The Role Of Spirituality Among Schizophrenia Patients: An Integrated Literature Review, Sarah Bieber

Grace Peterson Nursing Research Colloquium

Abstract

Background: Over the past 30 years, the field of psychology has evolved to become more receptive towards spirituality as an influential concept in the recovery of many mental health illnesses. The role of spirituality as it relates to recovery for patients living with schizophrenia, however, has not been effectively explored. In order to induce a spiritual sense, one must have an ability to think and reflect abstractly; however, this requirement conflicts with the schizophrenic mind’s preference for concrete thinking. It is questionable whether patients with schizophrenia regard the role of spirituality as it relates to their recovery in the …

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 …

Racial Microaggressions Within The Field Of Nursing, Theresa Farris, Elizabeth Hartman, Young-Me Lee

Grace Peterson Nursing Research Colloquium

Racial microaggressions (RM) have transitioned into a subtle form of contemporary racism and are potentially involved within our communication as healthcare providers. Though cultural competency is addressed within nursing education, this RM phenomenon continues to happen in everyday discourse and can occur with little or no awareness on the part of Caucasians. The aim of this study was to gain a better understanding of how RMs against African Americans exist within the field of nursing and how their underlying discrimination increases the marginalization of this community. A detailed search was conducted using CINAHL, PsycInfo and ProQuest databases using the keywords: …

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 …

Outdoor Physical Activity And Mental Health, Justyna Helinska, Elizabeth Hartman

Grace Peterson Nursing Research Colloquium

Abstract

Background: According to the Center for Disease Control and Prevention (2013), about 25% of US adults have a mental illness. The economic demand that treatment for mental illness involves is extensive. Recent evidence suggests that the outdoor environment that consists of exercise may have an effect on mental health. Present review of literature is unclear how effective this intervention might be if incorporated into an inpatient psychiatric setting.

Objective: Examining the benefits of incorporating outdoor physical activity as an intervention to treat psychiatric disorders.

Method: The literature search for the research topic was found using the databases of: CINAHL …

A Demonstration Project To Address Juvenile Drug Addiction, Mary Ellen Broaddus

Graduate Theses, Dissertations, and Capstones

The rise in adolescent drug use and addiction is becoming a worldwide phenomenon. An eleven year study of youth in European countries found drug use widespread and increasing (Molinaro, Sicilian, & Curzio, 2011). In 2013 there were over 2.8 million new users of illicit drugs, over half of whom were under 18 years of age (‘Drug Facts’, 2015).

Adolescents are at unique risk because biochemical distinctions in their brains, when compared with adults, prompt more risk-taking behaviors (Gallager, 2014). Health risks are considerable and include hypertension, stroke, convulsions and seizures, and liver disease such as cirrhosis and hepatitis. In 2013 …

2017-2018 Graduate Studies In Nursing Handbook, Otterbein Office Of Graduate Programs

Graduate School

A graduate handbook for the Graduate Studies in Nursing programs at Otterbein University.

Mental Illness Stigma, Socially Acceptable Treatment, And Barriers To Health, Frances Renee Gellert

Independent Study Project (ISP) Collection

This paper discusses the topic of mental illness stigma and treatment in Uganda as explored through internship in the Social Work Department at Butabika National Referral Mental Hospital. The objectives of this project were to complete a meaningful internship while exploring causes of mental illness in Uganda, contradictions between traditional and modern approaches to treatment, and the affect of stigma on mental well-being. The internship included a total of 120 hours at Butabika Hospital. Individual research using documentary and literature review methods accompanied the internship. Butabika Hospital did not consent to the completion of formal research at, so any conclusions …

Comparison Of Two Nicotine Dependence Measures For Use With Korean American Women: The Ftnd And Autos, Sun S. Kim Phd, Aprn-Bc

Asian/Pacific Island Nursing Journal

This study compares psychometric properties of the Fagerström Test for Nicotine Dependence (FTND) and Autonomy over Tobacco Scale (AUTOS), which are measures of nicotine dependence. This study is a secondary analysis of data obtained from a smoking cessation study conducted with 49 Korean American women. We compared the FTND and AUTOS assessed at baseline regarding their internal consistency reliability and concurrent and predictive validities. The AUTOS outperformed the FTND in reliability and concurrent validity by yielding a higher Cronbach’s alpha and having significant relationships with smoking-related variables such as age at smoking onset, perceived risks of quitting, and self-efficacy in …

Education Program Using Non-Pharmacologic Support During Benzodiazepine Reduction In Patients With Anxiety Disorders, Kelly D. Kearney Dnp, Rn, Pmhnp-Bc, Diane Wardell Phd, Whnp-Bc

Journal of Nursing & Interprofessional Leadership in Quality & Safety

A private mental health clinic developed an initiative to aid patients with anxiety disorders to taper their use of benzodiazepines. Based on best practices, a treatment protocol was developed in which patients attended 4 sessions (1 per month) in which they combined instruction in non-pharmaceutical anti-anxiety techniques (guided imagery, mindfulness meditation, deep breathing, progressive muscle relaxation, exercise, emotional freedom) with cognitive behavioral therapy and use of selective serotonin re uptake inhibitors. Participants experienced a reduction in benzodiazepine use. This small scale initiative showed that the holistic approach to anxiety management was an effective plan to decrease the use of benzodiazepines …

A Review Of Treatment Programs For Offenders With Co-Occurring Addictive And Mental Disorders: Support For Booster Interventions, Annette T. Maruca, Deborah Shelton

Journal for Evidence-based Practice in Correctional Health

Background: Treatment interventions are essential in supporting psychosocial skills, health promotion and successful reintegration to community living for incarcerated persons. Booster interventions are presumed to be important methods for maintaining the effects of treatment effects for persons with addiction and mental disorders, but there has been remarkably little empirical attention to this assumption. Objectives: This review aims are: (1) to describe existing literature on treatment programs for offenders with addiction and mental disorders in the reentry process, and, (2) to add to the literature on this topic by evaluating the impact of booster interventions upon maintenance of treatment effects and …

Evidence-Based Verbal De-Escalation Techniques For The Family Nurse Practitioner: Education And Simulation, Rachael K. Misitano

Doctor of Nursing Practice (DNP) Projects

Background: Healthcare workers are 4 times more likely to be exposed to workplace violence than workers employed in private industry, with assault rates as high as 7.8 per 10,000 workers. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults, and or threats of assault, directed toward persons at work or on duty” (OSHA, 2015, p. 2). Verbal de-escalation techniques that assist with care of the agitated patient are not routinely taught to Family Nurse Practitioners (FNPs) throughout their years of advanced coursework, yet it is something they are likely to encounter …

Improving Communication And Satisfaction Through Hourly Rounds, Karen E. Sondeno

Master's Projects and Capstones

The focus of this CNL project is quality improvement using high quality hourly rounds to achieve improved patient satisfaction and communication with nurses. It was determined by reviewing survey results that patient satisfaction and nurse communication is below National levels. Data shows that rounds are not being done well on a medical unit before the improvement project. It is proven that patients receive and perceive higher quality care and communication with increased nurse presence at the bedside. The population of the medical unit has high numbers of confused/dementia, and dual-diagnosis patients. It was determined that the unit would benefit from …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Delirium: A Cnl-Led Protocol To Clear Up The Confusion, Shanda N. Whittle

Master's Projects and Capstones

Project objectives: Delirium is a form of organ failure defined as an acute change in cognition, evidenced by altered consciousness and impaired attention that fluctuates over time, and is associated with increased morbidity, mortality, and healthcare services utilization. In the hospital where this evidence-based practice project took place, there was no formal protocol or guideline for assessing or managing delirium. Therefore, this project focused on improving the practice of identifying patients at risk for developing delirium with the AWOL tool and treating patients with signs and symptoms of delirium found using the Short-CAM assessment. Population and setting: This project took …

Genetic Influence On Resilience To Potentially Traumatic Events, Kosuke Niitsu

Theses & Dissertations

Most individuals experience at least one potentially traumatic event (PTE), such as a natural disaster. When exposed to PTEs, some individuals are more vulnerable to develop psychopathology, such as Post-Traumatic Stress Disorder (PTSD). In contrast, others are less adversely affected by PTEs, who are often described as “resilient”. A concept analysis of resilience (Manuscript #1) revealed: the antecedent is PTE; the defining attributes are ego-resiliency, emotion regulation, heredity, and social support; and the consequences are none to mild psychopathological symptoms and positive adaptation. Based on a systematic review of genetic influence on resilience (Manuscript #2), the following 10 polymorphisms were …

A Clinical Practice Change Initiative To Incorporate Animal Assisted Therapy In Advanced Practice Registered Nurses' Clinical Practice For Children And Adolescents, Donna Rae Cowell

Doctoral Projects

Background: Children and adolescents mental healthcare needs is vital for the future of our nation’s welfare (American Psychology Association, 2014). Research has indicated AAT may be a considerable choice to help with pediatrics mental healthcare and may be utilized as an adjunct to enhance the care within the psychiatric healthcare field (Chandler, 2012). AAT has become popular within the healthcare realm (Friesen, 2009; Uyemura, 2016) and is a unique method for providing “patients” health care, which may improve patient outcomes (Chandler, 2012; Cowell, 2013; McCullough, 2016; McQuarrie & Urichuk, 2008). Research supports that “providers” in the health care field may …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …