Psychiatric and Mental Health Nursing Commons^™

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Charting The Course: Improving Psychotropic Medication Documentation Through Staff Education To Promote Patient Safety And Cms Compliance, Anne J. Bertram Rn

Master's Projects and Capstones

The University of San Francisco master’s level nursing program culminates with a clinical nurse leader (CNL) quality improvement project. The objective of this project is to reinforce the program’s didactic CNL classes by allowing students the opportunity to design, implement, and analyze a quality improvement project in a microsystem. SETTING: Skilled nursing facilities often prescribe psychotropic medications to help manage residents’ behavioral and psychological symptoms. Due to the possibility of side effects and increased sedation, there are concerns for patient safety and quality of life. Inadequate management of these patients and symptoms compromises patient safety and breaches state and federal …

From Fear To Familiar: Decreasing Technology Anxiety Among Older Adults In A Senior Community, Regina Rayz

Master's Projects and Capstones

Objective: Older adults (defined by the WHO as those 65 and older in developed countries) are more susceptible to technophobia than younger adults (Song et al., 2025). The fear and anxiety occurs with use of smartphones, tablets, social media, and telehealth and is associated with higher rates of social isolation and reduced autonomy. Technology-use anxiety is a preventative obstacle that inhibits both technology acceptance as well as overall health (Kim et al., 2023). Aim: To reduce technology-related anxiety among older low-income adults living in a senior residential facility in Richmond, CA by at least 25% using a brief, individualized technology …

Matrescence: An Emerging Concept For Birth Worker Practice, Kelsey B. Green

DNP Qualifying Manuscripts

The maternal mental health (MMH) crisis, affecting up to 25% of birthing individuals, is exacerbated by significant gaps in perinatal support. While birth workers are uniquely positioned to provide care, they often lack specialized training beyond basic screening checklists to address the complex transition to motherhood, defined as matrescence. This clinical innovation proposal outlines a matrescence-informed educational curriculum, guided by the Comprehensive Model of Mental Health during the Perinatal Period. The intervention is designed to build tangible, implementable skills, training birth workers to: (1) operationalize matrescence as a psychoeducational tool to normalize distress; (2) use clinical differentiation to distinguish the …

Mental Wellness: Breaking Down Barriers To Mental Health Treatment For Veterans, Merita Dallta

Capstones

No abstract provided.

Implementation Of The Modified Severity Assessment Scale (Msas) For Alcohol Withdrawal In An Inpatient Psychiatric Unit, Grace R. Lindsey

Doctor of Nursing Practice

Background: Alcohol withdrawal is a potentially life-threatening condition frequently seen in psychiatric inpatient settings, especially among individuals with co-occurring alcohol use disorder and mental illness. The Clinical Institute Withdrawal Assessment for Alcohol Scale-revised, while widely used, depends on patient self-report, making it less effective for individuals with altered mental status or psychosis.

Purpose: This quality improvement project implemented the Modified Severity Assessment Scale, an objective, observation-based alcohol withdrawal protocol, in an inpatient psychiatric setting to improve safety, treatment accuracy, and care standardization.

Objectives: The project focused on ensuring full staff adoption of the protocol, reducing intensive care unit transfers …

Examining And Addressing Increased Hospital Inpatient Falls Rates At An Urban Community Hospital, Juan Lira

Doctor of Nursing Practice

Abstract

Background: Falls are the leading cause of reported injuries within the hospital setting. Injuries from falls occur in about20-45% of the time and is the leading cause of injury and injury death among the adult population. Inpatient falls are associated with an additional $14,0000 per occurrence and a prolonged hospitalization by 6.3 days. Increased falls rates affect hospitals rating, accreditation and reimbursements. This hospital is experiencing inpatient falls that exceed national average and corporate goals.

Purpose: The purpose of this project is to reduce the hospital falls rate by 10% within 90 days of initiating evidence-based evaluation and facility-wide …

Implementation Of An Information Sheet For Pediatric Patients With Autism Spectrum Disorder In An Inpatient Setting To De-Escalate Aggressive Behaviors And Reduce Seclusion Rates, Megan R. Castro

Doctor of Nursing Practice

Introduction: Research shows that most seclusion events in pediatric psychiatric settings involve pediatric patients with neurodevelopmental disorders, particularly autism spectrum disorder (ASD). A lack of provider expertise contributes to elevated seclusion rates, highlighting the need for evidence-based, ASD-informed care.
Purpose: To reduce seclusion events within a pediatric psychiatric facility in South Texas, by implementing an evidence-based intervention upon admission that could decrease aggressive behaviors and the likelihood of requiring seclusion. Evidence summary: Literature and guidelines underscore the importance of identifying sensory triggers and calming strategies at admission. Collaborative care and personalized interventions, such as a patient information sheet that identifies …

Barriers To Mental Health Access Among Immigrant Populations In The U.S., Cecilia Menzinger

Capstones

No abstract provided.

Mental Health In Adult Oncology Patients, Jenna Pope

Capstones

Adults with cancer suffer from mental challenges that frequently go under diagnosed and under treated (Fernando et al., 2023). This can lead to lower quality of life, resulting in reduced adherence to treatment, more frequent hospital stays, increased healthcare costs, and increased mortality rates (Matthews et al., 2025). There are currently no policies on mental health screening for adult oncology patients at every outpatient appointment. By consistently utilizing standardized screening tools such as the PHQ-9 and GAD-7 during all oncology appointments, this can close the gap in policy to address mental health needs of these individuals. It is vital to …

Improving Early Detection Of Suicidal Ideation Through Routine Screening In Adults With General Anxiety Disorder, Brittanie N. Bush

Doctor of Nursing Practice

Suicide is a leading cause of death in the United States, with anxiety and depression recognized as independent risk factors for suicidal ideation (Centers for Disease Control and Prevention, 2024 September 26; Grant et al., 2023; Li et al., 2022; Moon et al., 2025; Wiebengo et al., 2021). Incorporating valid screening tools like the General Anxiety Disorder-7 and the Columbia-Suicide Severity Rating Scale can help identify suicidal ideation early, enabling quicker provider intervention (Johnson et al., 2019; O’Connor et al., 2022). The purpose of this project was to implement the Columbia-Suicide Severity Rating Scale as a standardized screening tool for …

Enhancing Adherence To Veterans Affairs/Department Of Defense And American Psychiatric Association Clinical Guidelines For Alcohol Use Disorder, Corinna M. Trevino

Doctor of Nursing Practice

Alcohol use disorder continues to be significantly undertreated within outpatient behavioral health settings, particularly concerning pharmacological interventions. Despite the presence of robust national clinical guidelines recommending medications such as naltrexone for individuals with moderate to severe dependence, the rates of prescribing these medications remain modest owing to inconsistent screening procedures, limited referral practices, and provider follow-through barriers. This project was implemented at a substance use treatment center in a large metropolitan area to improve adherence to clinical practice guidelines. The purpose of this project was to increase prescribing of naltrexone and improve referral for patients with moderate to severe alcohol …

Psych Assessment In The Er, Bailey J. Thompson, Addie Cowger, Hailie Hollis

Scholars Week

An immense amount of patients who enter the emergency department, whether for a psychiatric illness or not, struggle with mental health challenges. By creating a standardized routine and checklists for the care of high-risk psychiatric patients, the new quality and consistency can enhance patient experiences. This process will start at the triage stage and continue throughout their stay. Presenting the supportive research to the emergency department staff and introducing these changes gradually will help with staff buy-in and become a more sustainable process. Finally, with a structured approach, psychiatric patient outcomes will benefit significantly.

Compassion Fatigue And Burnout In Community-Based Psychiatric Staff, Faith Carini-Graves

Advances in Clinical Medical Research and Healthcare Delivery

Community-based psychiatric staff, such as the Youth ACT teams that are being initiated across New York State, are at risk for compassion fatigue due to their proximity to the trauma of their patients. This literature review explores current evidence that is available on the topic and grapples with what can be done to support psychiatric staff who work in the community with patients who experience trauma.

From Student To Pmhnp: Your Roadmap To Certification, Practice, And Success, Dena L. Hinkle

Nursing Department Faculty Conferences

This poster presentation highlights the changes made to the final course in the Psychiatric Mental Health Nurse Practitioner program based on student and faculty feedback. Students are provided with the knowledge and tools to navigate certification, licensure, job selection, and clinical practice. Participants engagee in activities to enhance their resumes/CVs, practiced conducting intake assessments, and developed strategies for a successful transition into practice.

The Efficacy Of Emdr Therapy Compared To Tf-Cbt In Adopted Children To Manage Post-Traumatic Stress: An Integrative Review, Grace Ann Steiner

Senior Honors Theses

This integrative review examines the efficacy of eye movement desensitization and reprocessing (EMDR) therapy compared to trauma-focused cognitive behavioral therapy (TF-CBT) in managing post-traumatic stress disorder (PTSD) in adopted children. Children adopted from foster care tend to experience more adverse childhood experiences (ACEs) and maladjustment issues when compared to the general population, which necessitates effective therapeutic interventions to reduce PTSD symptoms and emotional dysregulation. Through analysis and comparison of the data, it was determined that both EMDR and TF-CBT effectively alleviated trauma-related symptoms, although one technique is not necessarily always more effective or efficient than the other. Along with reviewing …

Quality Improvement Initative To Reduce Falls Among Geriatric Patients In The Inpatient Mental Health Setting, Regina Johnson

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are widely recognized as a leading cause of injury and hospitalization among older adults, with geriatric psychiatric patients at particularly high risk due to polypharmacy, cognitive impairment, and mobility challenges. At the project site, baseline audits revealed inconsistent use of structured fall risk tools, limited nurse-driven medication review, and gaps in post-fall documentation. The absence of an embedded electronic health record feature for medication review highlighted a significant practice gap requiring intervention.

Aim of the Project: The aim of this quality improvement (QI) project was to reduce fall risk in a geriatric psychiatric hospital through structured post-fall medication …

Implementing A Standardized Ssri Tapering Protocol In The Outpatient Setting, Chelsea Sopo-Ngwa

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Selective serotonin reuptake inhibitors (SSRIs) are one of the most prescribed antidepressant medications in the outpatient psychiatric setting. Abrupt discontinuation or improper tapering of these medications may result in SSRI withdrawal symptoms. Adverse effects may lead to poor patient outcomes and increase healthcare utilization. A baseline chart review and provider readiness survey within the outpatient psychiatric practice revealed inconsistency in provider documentation related to SSRI tapering plans, patient education, and follow-up planning. The gap in practice highlighted the lack of a standardized SSRI tapering protocol to guide evidence-based medication tapering practices and promote patient safety.

Aim: The …

Exploration Of The Cultural Beliefs, Values, And Practices Of African American/Black Women Or Birthing Persons Regarding Postpartum Depression: A Focused Ethnography, Stephanie Jacobs

Electronic Theses and Dissertations

Introduction: Postpartum depression (PPD) is the most prevalent perinatal mental health illness in women, affecting approximately 10% to 20% of all women in the United States, and a disproportionately higher number of African American women. The aim of this study was to explore the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression.

Research Question: What are the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression?

Methodology: A focused ethnography was chosen for this study and consisted of semi-structured interviews. Data was transcribed and analyzed …

Enhancing Nurse Competence And Self-Efficacy In Delivery Of Medication Education At Discharge: A Quality Improvement Project Using The Teach-Back Method., Quinesia James

Doctor of Nursing Practice Papers

Medication nonadherence in pediatric psychiatric care contributes to worsening symptoms, delayed developmental progress, and increased hospitalizations. Adherence rates remain as low as 30–60%, accounting for up to $300 billion in avoidable healthcare costs annually. Low health literacy and inconsistent education strategies further complicate adherence. This quality improvement project took place on the child and adolescent psychiatric units at the project site, a large teaching hospital in a metropolitan area in the south-central United States, which serves patients aged 5–17 with complex mental health needs. The initiative aimed to improve nurses’ competence, self-efficacy, and time efficiency in delivering medication discharge education …