Date Available

12-12-2019

Year of Publication

2019

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Patricia B. Howard

Committee Member

Dr. Peggy El-Mallakh

Committee Member

Dr. Chizimuzo Okoli

Co-Director of Graduate Studies

Dr. Tanya Wiese

Abstract

Abstract

BACKGROUND: Mental health is a state of well-being in which an individual is able to acknowledge ability levels, cope with the normal stresses of life, be a productive member of society and contribute to the community. An important consideration for DNP prepared nurses is implementing principles of the Collaborative Care Model as a guiding framework to improve access to evidence-based mental health care in a medical care setting.

PURPOSE: The purpose of this DNP project was to examine the demographic, clinical and treatment characteristics of patients with both medical and psychiatric diagnoses admitted to an Intensive Care Unit (ICU) of a hospital in a large healthcare system located in a metropolitan area in the southeast United States.

METHODS: For the study in this DNP project, an exploratory, descriptive design with a retrospective medical record review was conducted on 100 patients with both medical and psychiatric diagnosis admitted to the ICU between July 1, 2018 and December 31, 2018. This study was an exploration of demographic, clinical and treatment characteristics of patients with both a medical and psychiatric diagnosis admitted to the ICU during the study period. The relationships among and between the psychiatric medication reconciliation status, type of psychiatric treatments received, length of stay and discharge disposition of the study sample were explored.

RESULTS: Those who had psychiatric diagnosis on admission were more likely to be female (60.0% vs. 40%), have a neurological condition as the admitting diagnosis (63%) and suffer from co-existing medical diagnosis including cardiac/pulmonary (83%). The nonexclusive, primary psychiatric diagnosis was anxiety (75%), follow by depression (63%) with nearly three quarters of the sample on a psychiatric medication prior to admission (71%). The most common psychiatric medication was an antidepressant/mood stabilizer (56%). There were no significant differences in admission diagnosis, co-existing medical diagnosis, restraint use, PRN medication use, psych consult, disposition or length of stay between those with and without psychiatric medications on admission.

CONCLUSION: There remains limited research concerning collaborative care in the inpatient healthcare setting. The preliminary findings of this DNP project suggest the need for more exploratory research that can guide practice and policies to enhance care for patients with psychiatric and medical comorbidities in the ICU setting.

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