Posted: September 6th, 2023

Implementing Evidence-Based Practice for Psychiatric Patients in Acute Hospital Setting

Using the suggested/requested format above, please respond to the following questions for your discussion post:
1. In your current (or previous) nursing position, describe a practice problem that needs addressed.
2. Describe one or more ideas from the literature for a potential DNP project to address this practice problem.
3. Describe the type of support needed from the organization if you were to implement a DNP project at this or any organization.

In my current nursing practice we have a major issue with managing psychiatric patients that come into the medical surgical unit and ICU. Staff are not properly trained on how to manage these patients and the protocols and tools that are in place can stand to be updated. I would like to Implement Evidence Based Practice for Alcohol withdrawal, dual diagnosis treatment, substance use and mental health in an acute hospital setting. It is a coincidence that the company has partnered with another local company and have decided to hire a PMHNP to be on call and work remote to serve the population that comes to the emergency room with expected addiction. I have already applied for the position and have been accepted. I plan on developing new policies and procedures and updating protocol tools so that we can better serve this population as a small community hospital to be able to provide proper services when they are a patient on our units and to provide proper follow up care and get these patients the much-needed resources and services. Right now when a patient comes in requesting detox once determined stable they are discharged without a resource sheet or no follow up.

Suggested Student Discussion Post Format
Format Suggestions: Add level 1 headers (bold font/centered) to clearly identify each discussion prompt using summary statements rather than copy/pasting the entire discussion prompt. Also, use bold font to highlight and identify questions posed to your peers.
Sample Discussion Instructions: Based upon the concepts learned during week one, respond to the following:
• How does incivility affect the academic environment?
• Find a peer reviewed article on this topic and discuss one behavior considered as incivility.
• As an academic nurse educator, how would you promote a civil classroom?
Sample Student Initial Post:
Incivility in the Academic Environment
Incivility in the academic environment can significantly impact many different aspects. Relationships, learning, patient safety, and many other areas can all be negatively affected by incivility (Clark, 2017). As we discuss incivility in the learning environment, we must keep the focus of education as our primary goal. Behaviors that impair learning may be considered uncivil by students, faculty, or both. Faculty are responsible for controlling the classroom and learning environment in a way that allows all to learn effectively.
Behaviors of Incivility
One uncivil behavior that is often unaddressed is students talking in class. Many students view this behavior as uncivil because it distracts them from their learning. Impaired learning is an issue in any classroom, but much more so in a profession like nursing that requires a strong foundation of knowledge to provide safe and effective patient care (Aul, 2017; Rawlins, 2017). Thus, faculty need to ensure that they are facilitating a learning environment for all students. In addition, many faculty also view student conversations in class as disrespectful and distracting to their thought process as they are teaching (Rawlins, 2017). Allowing uncivil behavior to continue gives the students the impression that this behavior is acceptable, and the behaviors may continue outside the classroom and learning environment to the professional workplace (Aul, 2017).
Addressing Civility
Clark (2017) provides many practical tips on fostering civility in the classroom. She encourages faculty to set mutually agreed upon ground rules for classroom behavior with students on the first day of class. Sample classroom ground rules that my past students have utilized include giving mutual respect, active listening, talking without interrupting, freely sharing ideas, no side conversations during class, and no use of cell phones unless related to class discussion. If we consistently consider the needs of others and the overall goal, we can come together in a professional manner that is conducive to learning for all. As a student, how have you experienced incivility in the classroom and how was it addressed by faculty?
References
Aul, K. (2017). Who’s uncivil to who? Perceptions of incivility in pre-licensure nursing programs. Nurse Education in Practice, 27, 36-44. http://dx.doi.org/10.1016/j.nepr.2017.08.016
Clark, C. (2017). Creating and sustaining civility in nursing education (2nd ed.). Sigma Theta Tau International.
Rawlins, L. (2017). Faculty and student incivility in undergraduate nursing education: An integrative review. Journal of Nursing Education, 56(12), 709-716. http://dx.doi.org/10.3928/01484834-20171120-02

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Implementing Evidence-Based Practice for Psychiatric Patients in Acute Hospital Setting

Practice Problem
In my current nursing position, we face a challenge in managing psychiatric patients who come into the medical surgical unit and ICU. Staff are not appropriately trained to manage these patients, and the protocols and tools in place require updating. Patients with dual diagnoses of substance abuse and mental health issues require more specialized care, which is currently unavailable. Upon their discharge, they do not receive any follow-up resources or services. This gap in care can lead to an increase in readmissions, decreased patient satisfaction, and an overall negative impact on patient outcomes.

Potential DNP Project Ideas
To address this practice problem, one potential DNP project could be to implement Evidence-Based Practice for Alcohol Withdrawal, Dual Diagnosis Treatment, Substance Use, and Mental Health in an Acute Hospital Setting. This project could involve developing new policies and procedures, updating protocols and tools, and providing specialized training for staff to better serve this population. Additionally, implementing a follow-up care plan for patients after discharge can help them access much-needed resources and services.

Type of Organizational Support Needed
To successfully implement this DNP project, organizational support is crucial. The organization should provide financial resources, including funding for the project and training programs for staff. The organization should also allocate time for staff to participate in the project and allow for the necessary changes to be made to existing policies and procedures. Finally, the organization should support the dissemination of the project outcomes to promote its sustainability and future growth.

As a nursing student, how have you seen psychiatric patients being managed in acute care settings? Do you think there is a need for improvement, and if so, how can you help address this issue?

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