Annual Conference Friday Afternoon Abstracts

3031: Women's Experiences Living With and Recovering From Depression
Susan Jarchow, PhD, MSN, BSN, RN

PROBLEM STATEMENT: The purpose of this study was to explore the perspectives of women living with depression in the context of their daily lives, including (a) experiences of symptoms; (b) their exposure to social adversity; and (c) their efforts at recovery in the context of their larger sociocultural and sociopolitical environments. THEORETICAL FRAMEWORK: Social theories of health provide a framework that accounts for the social risk factors for mental illness disproportionately present in women's lives.  Current conceptualizations of mental health recovery encompass more than symptom management, and include improving health and wellness, gaining a sense of purpose, and living a self-directed and meaningful life. METHODS & DESIGNS: Women (n = 17), who self-identified as having experienced depression at some time in their lives, participated in two in-depth face to face interviews with the researcher 5 to 14 days apart to discuss their experiences living with and recovering from depression.  Interview transcripts were analyzed using thematic analysis. RESULTS: Six broad themes were identified:  (a) Suffering Adversity in Childhood and Adolescence; (b) Shutting Down and Giving Up; (c) Isolation, Not fitting In, and Social Stigma; (d) Managing Symptoms and Experiences with Healthcare;(e) Coming to Terms: Facing It and Working through It; and (f) Becoming a Resource Person: Connecting, Learning, and Giving Back. IMPLICATIONS: Findings provide guidance for interventions to better meet the mental health needs of women living with and recovering from depression. Repeating this study using a longitudinal or mixed-methods design and a more diverse sample. Conducting further research about interventions women identified as most helpful.


3032: NewYork-Presbyterian’s Nursing Suicide Risk Inventory (NSRI): A Daily Nursing Suicide Risk Tool for the Inpatient Psychiatric Setting
Brynne Calleran, BSN, BS, RN-BC

PURPOSE: To provide inpatient psychiatric-mental health nurses with a comprehensive picture of patient suicide risk while enhancing nurses’ suicide risk competency and improving patient safety. SUMMARY OF EVIDENCE: Per the Joint Commission on the Accreditation of Healthcare Organizations’ Sentinel Event Alert 56 (2016), the most common root cause of inpatient suicide is a failure in clinical assessment. Though the literature is saturated with psychiatrist/M.D.-specific suicide risk assessment tools, and narrowly-focused screening tools for ambulatory and triage settings, a conspicuous gap exists regarding nursing-specific suicide risk assessment tools for the inpatient psychiatric setting. VALIDATION OF EVIDENCE: An extensive literature review on nursing suicide risk assessment was completed by NYP’s Nursing Practice Council prior to the NSRI’s development. All twenty items on the final inventory are supported with scholarly evidence citations. IMPLICATIONS: Use of the NSRI will improve patient safety and nursing suicide risk competency.


3033: Designing and Delivering Quality Distance Education: Challenges and Opportunities to Teach the Next Generation of PMHNPs
Susan Blaakman, PhD, PMHNP-BC; Holly Brown, DNP, PMHCS-BC, PMHNP; ANDREW WOLF, EdD, RN, ACNP-C, CNE; Joseph Gomulak-Cavicchio, MS Ed.

PURPOSE: Online graduate nursing education has been steadily increasing over the last decade, yet strategies for designing and delivering quality psychiatric mental health nurse practitioner (PMHNP) programs are not widely shared. The purpose of this presentation is to share our experience redesigning a PMHNP curriculum based on best practices for online learning. SUMMARY OF EVIDENCE: Evidence suggests that distance learning technologies can be effective in educating PMHNP students in didactic and clinical domains. Effective online education depends on a team approach, with expert faculty, instructional designers, and information technology staff collaborating to develop effective learning experiences. Well-designed online courses, enriched with distance technology, enhance student satisfaction, engagement, and academic achievement. VALIDATION OF EVIDENCE: Our initial evaluation shows that our courses are aligned to best-practices evidenced by the Quality Matters rubric. Participants will be engaged in discussion and guided practice of best practices in online course design. IMPLICATIONS: Developing and evaluating best practice educational approaches can only benefit our profession and consumers.


3034: An Overview and Efficacy of a Psychiatric Intensive Care Unit in Managing Aggression among Individuals With Serious Mental Illness
Lawrence Blair, RN; Colleen Russo, PNP

PURPOSE: Creation of our psychiatric intensive care unit (Transitions) came as a response to high rates of aggression in a large psychiatric hospital. SUMMARY OF EVIDENCE: First created in the 1970s, international research has found that PICUs are effective in reducing staff time lost due to injuries, lowers risk for violence, reducing aggressive incidents, and leads to greater improvement in psychiatric conditions. VALIDATION OF EVIDENCE: We examined rates of seclusion and restraints (S/R) on Transitions compared to other units. Aggressive incidents were tracked using the Staff Observation of Aggression Scale – Revised (SOAS-R). IMPLICATIONS: The Transition model may be an effective means to mitigate aggression. Future research will explore aggression in greater detail.


3035: How-to be Anorexic, No Wannarexics Allowed
Sattaria Dilks, DNP, APRN, PMHNP-BC, FAANP; Jana Swearingen, RN, BSN

PURPOSE: “Pro ana” is a term used to describe individuals who see anorexia and other Eating Disorders (EDs) as lifestyle choices within an emerging cyberspace subculture. This culture manifests itself through hashtags like #proana and #thinsperation on social media sites and how-to blogs with advice on how to become anorexic. Providers should be aware of this culture and begin assessing their patient’s internet use. SUMMARY OF EVIDENCE: Recent studies indicate these blogs can be detrimental/helpful to users. VALIDATION OF EVIDENCE: Currently, the impact of these blogs on recognition and treatment of EDs is unknown. IMPLICATIONS: In the future the role of this new culture on patient’s lives and treatment plans should be examined by providers. Are the blogs teaching more women how-to become anorexic? Do they have the potential to reach a younger audience? Could these blogs cause a surge of ED’s? Given the mortality rate with ED’s it could become an even more serious public health concern.


3036: Violence and the Brain
Evelyn Perkins, RN, MS, PMH-BC, NE-BC

PURPOSE: Urban communities and their healthcare systems propose that antecedents to gun violence are complex and multifaceted. The Center for Disease Control and Prevention, under pressure from the National Rifle Association, halted research on gun violence in 1996. Thus there is no government sponsored national database on gun violence. However, many urban cities have identified gun violence as a public health crisis. Chicago reported that gun violence cost the city and its hospitals $2.5 billion annually. The psychological and emotional trauma to victims of gun violence and their families cannot be measured in dollars. SUMMARY OF EVIDENCE: Translational research has started to study populations instead of individuals to determine antecedent causes, best practice interventions and predict outcomes. Neuroplasticity research has shown the amygdala and the prefrontal cortex are impacted in populations with chronic exposure to gun violence. Allport’s framework of how the human brain develops functional beliefs which are more powerful than explicit beliefs in driving violent behaviors will be discussed. VALIDATION OF EVIDENCE: Longitudinal Analysis from International Tobacco Control Four Country Survey showed changes in harmful behaviors are consistent with Cognitive Dissonance Theory. IMPLICATIONS: Nurses can work with high risk populations to replace standard practices that don't best serve high risk for gun violence populations.


3037: Military and VHA Panel: Navy, Air Force, Army, and VHA Collaboration and Behavioral Health Nursing Updates
JoEllen Schimmels, LTC, AN, PMHNP-BC, DNP; Sean Convoy, PMHNP-BC, DNP; Kevin Creedon, LtCol, USAF, PMHNP-BC; Scott Hutton, RN, PhD, MBA, VHA CO

PURPOSE: Behavioral health (BH) nursing in the military has its own unique processes and challenges. Each military service (Air Force, Navy and Army) will present the current state of BH nursing and provide updates in BH nursing from their particular services as well as discuss how this ties into the entire Military Health System. SUMMARY OF EVIDENCE: Military Health System policy and guidance will be reviewed as a way to present specific behavioral health needs related to the delivery of BH care and BH nursing. We will also describe the roles and responsibilities of behavioral health nurses as leaders and force multipliers related to readiness of our service members. VALIDATION OF EVIDENCE: Military Health System Service Members, Retirees and Dependents have specific behavioral health needs that general behavioral nursing personnel may not have a clear understanding of, and how the delivery of BH care in the Military Health System continues to evolve and what the future of BH nursing in the Military Health System as a whole and each individual Service (Navy, Air Force and Army). IMPLICATIONS: Help audience with an understanding of BH nursing in the military health system.


3041: APRN Council Interactive Panel
Dana Olive, PhD, PMHNP-BC; Kathryn Johnson, PMHNP-BC, PMHCNS-BC; Sattaria 'Tari' Dilks, DNP, PMHNP-BC, FAANP

PURPOSE: The purpose of the presentation is for APRN Council Steering Committee members to present results from this past year’s efforts to achieve both the APRN Council and APNA missions. The Interactive Panel will discuss: achievements in assisting PMH-APRNs to navigate such challenges as reimbursement issues & scope of practice issues, legislative trends in advancement towards achieving full practice authority, and how the APRN role is continuing to expand within different models of integrated medicine models emerging throughout the country. Time will be subsequently devoted to exploration of topics that members might find of importance for the APRN Council to address in the upcoming year. SUMMARY OF EVIDENCE: Current trends in APRN practice and advancement of the missions of APNA shape the activities of the APRN Council Steering Committee. VALIDATION OF EVIDENCE: Evidence is validated by : literature supporting the PMH-APRN role in varied clinical settings and data on APRN practice available through professional nursing organizations and State Boards of Nursing. IMPLICATIONS: The APRN Council Steering Committee members hope for movement towards expansion of PMH- APRN practice authority throughout the United States.


3042: Addictions Council Interactive Panel
Matthew Tierney, RN, MS, PMHNP-BC, ANP-BC; Carol Essenmacher, PMHCNS-BC, DNP

PURPOSE: The purpose of the Addictions Council Interactive Panel is to convene a forum where psychiatric nurses can discuss addictions-related issues with the goal of increasing their knowledge to enhance understanding and, ultimately, practice in this area. Substance use and addictive disorders are present throughout the lifespan, in all US populations. SUMMARY OF EVIDENCE: Unfortunately, substance use disorders are seriously undertreated. SAMHSA’s 2015 National Survey on Drug Use and Health estimated that 20.8 million US citizens (about 8 of the population) met criteria for a substance use disorder. At-risk populations include 78 million people who use tobacco products, and 17.3 million citizens with heavy alcohol use in the past month. Despite these numbers, in 2015 only 3.48 million adults received treatment for illicit drug or alcohol use disorders. VALIDATION OF EVIDENCE: APNA’s Addiction Council takes a national leadership role and is a professional resource for the identification and treatment of addictions and substance use disorders as they relate to psychiatric nursing. IMPLICATIONS: Wherever patients and families are on the disease spectrum, treatment is possible, and so is recovery: patients, families and communities can and do get better. Whole health begins with mental health.


3043: Compassion Fatigue: What is our Education Curriculum Plan?
Shirlee Davidson, MSN, CNS, RN; Diane Esposito, PhD, ARNP, PMHCNS-BC

PURPOSE: This interactive panel discussion will provide opportunities for participants to discuss Compassion Fatigue as it relates to psychiatric-mental health nursing practice and how it can be included in nursing curriculum to help students become aware, understand, prevent and cope, to avoid it from becoming a barrier to care-giving. SUMMARY OF EVIDENCE: Problems related to compassion fatigue, or staff burn out contribute to high costs and job dissatisfaction associated with nurse turnover rates. VALIDATION OF EVIDENCE: Brief review of literature, and resources will be presented via PPT before panel breaks up into their respective branches. IMPLICATIONS: Co-Chairs of the three branches will take notes, and report their group's plan on the Monthly Steering Committee Conference call, one month following the national conference meeting.


3044: Sexual Orientation, Gender Development and Psychiatric Mental Health Nursing of LGBTQ Children & Adolescents
Julie Carbray, PhD, PMHCNS-BC, FPMHNP-BC; Diane Weiland, PhD, PMHCNS-BC

PURPOSE: The purpose of this presentation is to provide educational material to address emerging sexual orientation, normal sexual exploration through gender dysphoria, across children and adolescents in psychiatric mental health nursing settings. Council members have asked for an evidenced based educational offering on how to best navigate these issues in their everyday nursing practice. SUMMARY OF EVIDENCE: Survey data collected at the child and adolescent interactive panel in 2016, found that complexities of emerging sexual orientation and associated challenges to milieu, outpatient care, family interactions pose challenges to child and adolescent mental health nursing. VALIDATION OF EVIDENCE: Evidence based review of iteratuire along with consultation with clinical experts will validate evidence for practice parameters discussed in this presentation IMPLICATIONS: This presentation may result in a paper that will guide practice for psychiatric mental health nursing.

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