Date Available

4-30-2024

Year of Publication

2024

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Andrew Makowski

Clinical Mentor

Dr. Caroline Bowman

Committee Member

Dr. Holly Stith

Abstract

Abstract

Background: Electroconvulsive Therapy (ECT) is a robust, versatile treatment option for many psychiatric disorders and diseases, but systemic low levels of knowledge and negative attitudes exist towards the procedure among healthcare workers, specifically among psychiatric RNs. The negative attitudes surrounding ECT are most attributable to a misunderstanding of its uses, efficacy, procedures, and safety. Psychiatric RNs hold more negative beliefs and misconceptions about ECT than any other group of healthcare workers who directly care for patients receiving the treatment. Psychiatric RNs also demonstrate poor understanding of ECT treatment procedures and outcomes. Current evidence-based practice shows that providing psychiatric RNs with an ECT educational module increases their knowledge of ECT and improves their attitudes towards the procedure.

Purpose: The purpose of this DNP project was to provide an educational intervention regarding ECT to psychiatric RNs caring for patients in a hospital or behavioral health unit setting. The specific aims were to 1.) evaluate changes in knowledge regarding ECT among psychiatric RNs, 2.) evaluate changes in attitudes toward ECT among psychiatric RNs, and 3.) evaluate changes in psychiatric RNs' likelihood of recommending ECT to patients.

Methods: This DNP project used a quasi-experimental pretest-posttest design and included psychiatric RNs. Data were collected via an online REDCap pretest and posttest survey using the standardized and validated QuAKE questionnaire. Data pertaining to psychiatric RN knowledge and attitudes concerning the uses, efficacy, procedure, and safety of ECT and the likelihood of recommending ECT to patients were collected and analyzed using a paired t-test.

Results: Psychiatric RN attitudes concerning ECT mean value scores increased from pretest (M = 3.47, SD = 0.63) to post-test (M = 4.27, SD = 0.38). The likelihood of recommending ECT mean scores increased from pretest (M = 3.42, SD = 0.90) to posttest (M = 4.33, SD = 0.49). Knowledge of ECT mean value scores increased from pretest (M = 75.56, SD = 9.28) to posttest (M = 81.25, SD = 9.23). Psychiatric RN attitudes towards and likelihood of recommending ECT demonstrated statistically significant improvement (p < .001 and p < .005, respectively).

Conclusions: This DNP project demonstrated that providing psychiatric RNs an ECT educational module produced statistically significant improvements in their attitudes towards ECT and their likelihood of recommending it to patients. Further research should allow the participants to observe the administration of ECT to become more familiar with the process and patient response. This could help determine if exposure to the administration of ECT affects psychiatric RN’s likelihood of recommending the procedure to their patients. Additionally, future research should identify the correlation, if any, between psychiatric RN ECT knowledge and attitudes and actual ECT treatment utilization rates. Future projects should include Advanced-Practice Registered Nurses to identify any change in post-intervention ECT referral frequencies.

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