Psychiatric and Mental Health Nursing Commons^™

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 …

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 …

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 …

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 …

Understanding Stigma In Pre-Nursing College Students, Claire E. Coxwell

Honors Theses

The purpose of this study is to understand patterns of stigma among pre-nursing students. Past research has suggested that college students stigmatize mental illnesses. This study builds upon existing research and looks at how pre-nursing students perceive some mental illnesses. The goal of the study was to find out if there are differences in the way that pre-nursing students stigmatize people with substance use disorders (alcohol and drug abuse) and eating disorders (anorexia nervosa and bulimia nervosa). Using an electronic data collection tool, 523 pre-nursing students were invited to take the Attitudes to Mental Illness Questionnaire (AMIQ) and respond to …

The Effect Of Mindfulness Meditation On Perceived Stress And Total Health Care Cost, Rachel Hale

DNP Projects

Background: Chronic stress can lead to hypertension, tachycardia, and increased inflammatory markers, which put individuals at risk for chronic diseases. Mindful meditation not only decreases perceived stress but also has the potential to decrease the risk of chronic diseases and health care cost. Purpose: The purpose of this mindfulness meditation project is to reaffirm that mindfulness meditation decreases perceived stress scores and to determine whether mindfulness meditation decreases health care cost. Theoretical Model: The relation of mindfulness meditation, lowered stress levels, and chronic diseases can be explained by the social cognitive theory (SCT). Applying SCT, meditation’s goal is to alter …

Mental Health Rehabilitation In Victims Of Sex Trafficking, Kayla E. Freemire

Senior Honors Theses

Human trafficking is a global epidemic that leaves victims with short- and long-term physiological, psychological, and sociological issues. The mental health needs of trafficked persons have become a topic of research in both medical and psychiatric circles. In order to comprehensively understand the mental health consequences of trafficking, the process must be defined and related to the mental health effects on its victims. The specific mental health disorders diagnosed within this population will be discussed. Treatments used currently for this population will be reviewed, along with future treatments presently being researched and evaluated regarding their potential for use in the …

The Effect Of Routine Adult Phq-2 Depression Screen And Scheduled Follow-Up Protocol In The Primary Care Setting, Alex F. Bikowski

Evidence-Based Practice Project Reports

Healthy People has projected depression to be the primary cause of disability by 2020; therefore routine depression screening has been prioritized as a national healthcare initiative. The purpose of this Evidence-Based Practice (EBP) project is to demonstrate that routine implementation of the 2-item Patient Health Questionnaire (PHQ-2) depression screener, along with a scheduled follow-up protocol for adults in the primary care setting, can improve current mental health practices regarding the identification of depression by clinicians. The evidence supports use of the PHQ-2 for routine adult depression screening, as long as a scheduled follow-up protocol is available for positive screens. This …

Benefits Of Having A Pet At College: Perception Of Today’S College Students, Morgan Jenkins

Georgia College Student Research Events

The present literature review examined data from 10 studies that examined the benefits of pet therapy and well-being. Florence Nightingale, a pioneer of nursing, recognized these benefits in the early 1800s when she used animals to provide support to mentally ill patients. Since then, pets, but mainly dogs, have been used across various populations and in numerous settings such as with geriatrics in nursing homes, in disaster relief, with war veterans suffering from PTSD, with inmates in correctional facilities, with terminal patients in hospice care, and with pediatric patients in the hospital setting. In all of these scenarios, findings suggest …

Examining The Relationship Between Medical Concerns And Overall Mental Health Rating, Sarah M. Wilson

Masters Theses & Specialist Projects

It is widely supported that there are significant, positive relationships between the occurrence of some mental health symptoms and physical illnesses. Research indicates that the burden experienced by those with a physical and mental illness are magnified compared to individuals who do not experience an illness. More specifically, one of the burdens experienced by individuals is the monetary burden of affording the necessary health services to properly manage their illness.

This study attempts to reveal a difference between mental health symptom count for individuals who do and do not experience difficulty affording health care for their physical problems. The first …

Developing A Clinical Tool For The Assessment And Diagnosis Of Pediatric Bipolar Disorder, Amanda Jill Horrocks

Doctoral Projects

Background: Pediatric bipolar disorder is a significant mental illness, characterized by changes in mood that can be abrupt, unpredictable, and extreme. The rate of diagnosis of this disorder has been increasing in recent decades. Purpose: A thorough review of existing literature was completed to inform practice. Additionally, a survey of clinician assessment practices was completed. Combining the information learned from the literature review, and the data from the clinician survey, a clinical tool has been created. This tool provides a thorough, multi-phasic process for the assessment and diagnosis of pediatric bipolar disorder. Method: Mental health clinicians were surveyed; respondents were …

Journal Of Mind And Medical Sciences: Translational And Integrative Mission, David L. Rowland, Ion G. Motofei

Journal of Mind and Medical Sciences

Initiated four years ago, Journal of Mind and Medical Sciences (J Mind Med Sci.) established the mission to publish papers on mental and medical topics in distinct but closely interrelated domains. The editorial policy especially encourages interdisciplinary and integrative perspectives, being equally focused on basic research and clinical investigations and short reports.

The journal adheres to the philosophy that high quality, original ideas and information should be readily accessible and freely shared within and amongst the scientific community. Accordingly, J Mind Med Sci. is an online, open access, non-for-profit journal which, because of individual/ private support, has levied no charges …

Weight Loss Maintenance: Women's Experience During Perimenopause, Karren B. Liebert

Dissertations, Theses, and Capstone Projects

Women’s health may be at risk during middle age, a time when women in the United States often gain weight. Being overweight or obese during perimenopause increases a woman’s vulnerability to disabling health sequela in later life, such as cardiovascular disease, diabetes, depression and osteoarthritis, all of which increase morbidity, mortality, health care costs and decrease quality of life. Stigma and discrimination related to overweight and obesity are associated with delay and avoidance of health care, and with poorer quality health care. Weight loss often is followed by weight regain within three to five years. This qualitative study was designed …

Understanding Alcoholics’ “Difficulty In Life”: An Empirical Comparison Of Alcoholics And Nonalcoholics, Keiko Ito

Asian/Pacific Island Nursing Journal

The Japanese success rate for alcoholism treatment is approximately 30%, indicating high relapse rates. Although “difficulty in life” is thought to contribute to alcoholics’ relapse, the characteristics of the phenomenon are unknown. This study examined the factors contributing to alcoholics’ difficulty in life. Alcoholic self-help group members, who indicated the extent of their difficulty in life and described the factors that contributed to this difficulty, completed a self-administered questionnaire. Participants’ hypersensitivity/grandiosity traits were also examined. A control group of nonalcoholic men also completed the questionnaire. Simple tabulation, descriptive statistics, Mann-Whitney U tests, and multivariate analyses were used to compare data …

Primary Care "Catches" Up With Behavioral Health, Michael Hannes Thorarinson

Nursing Theses and Capstone Projects

The problems caused by the lack of care coordination between primary care and behavioral health are well documented. Patients with uncontrolled mental health issues along with chronic health problems cost two to three times the health care dollars to manage than patients who have the same chronic health problems but without uncontrolled mental health issues. Despite this, in rural North Carolina, the de facto level of care coordination is none. Mental health and primary care are completely separate, distinct systems that do not routinely communicate. One of the identified barriers to care coordination is the lack of reimbursement for the …