RWH report rewrite

Progress Report: Effectively Managing Behavioral/Mental Health Illness on a Medical-Surgical Unit

Project Initiation

The project, “Effectively Managing Behavioral/Mental Health Illness on a Medical-Surgical Unit,” aims to integrate mental health care practices into the medical-surgical unit to improve patient outcomes and staff efficiency. The initiation phase involved:

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Literature Review: Comprehensive research on best practices for integrating mental health care in non-psychiatric settings (Happell et al., 2013).

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Stakeholder Engagement: Meetings with hospital administration, medical-surgical unit staff, and mental health professionals to gather insights and support (Kates et al., 2011).

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Baseline Data Collection: Assessment of current mental health care practices, patient outcomes, and staff preparedness.

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Project Approval: Obtaining necessary approvals from the hospital’s ethics committee and securing funding.

Progress with Intervention Implementation

The intervention includes training for staff, implementation of standardized screening tools, and integration of mental health professionals into the care team. Progress so far:

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Staff Training: Completed initial training sessions on recognizing and managing mental health conditions for 75% of the unit’s staff (Hanrahan et al., 2010).

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Screening Tools: Introduced the PHQ-9 and GAD-7 screening tools for depression and anxiety (Kroenke et al., 2001; Spitzer et al., 2006). These tools are now part of the admission process.

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Mental Health Integration: A part-time mental health nurse practitioner (MHNP) has been integrated into the team, available for consultations and direct patient care.

Other Issues with Project Initiation and Implementation

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Staff Resistance: Some staff members initially resisted the additional training and changes to workflow, citing increased workload. This was addressed through open forums and highlighting the long-term benefits for both patients and staff (Foster et al., 2011).

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Logistical Challenges: Coordinating schedules for training sessions without disrupting patient care required careful planning and adjustment.

Progress with Participants or Other Project Rollout Measures

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Patient Participation: High patient participation rates in mental health screenings, with over 80% of admitted patients completing the PHQ-9 and GAD-7 assessments.

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Feedback Mechanism: Implemented a feedback system for patients and staff to continuously improve the intervention. Initial feedback has been positive, particularly regarding the accessibility of mental health resources.

Unexpected Events

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COVID-19 Impact: The resurgence of COVID-19 cases led to temporary staffing shortages and delayed some training sessions. Additional online training modules were developed to mitigate this issue.

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Technological Issues: Initial technical difficulties with the electronic health record (EHR) system integration of the new screening tools required IT support, causing minor delays.

Need for Modifications to the Protocol, Timeline, or Budget

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Protocol Adjustments: Extended the training period by two weeks to accommodate staff availability and ensure comprehensive training.

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Timeline Revisions: Minor delays have been accounted for, with the overall project timeline extended by one month.

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Budget Adjustments: Slight increase in budget allocation for IT support and development of online training modules, currently within the acceptable range.

Progress with Evaluation

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Ongoing Monitoring: Continuous evaluation of patient outcomes, staff feedback, and process efficiency. Early indicators suggest an improvement in early identification and management of mental health issues.

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Preliminary Results: Initial data shows a reduction in patient distress levels and improved staff confidence in handling mental health issues (Balestrieri et al., 2021).

Timeline Comparison

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Current Status: On track with most project components, with some minor delays in staff training and EHR integration.

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Projected Completion: Expected to complete the project one month later than originally planned, accounting for unexpected delays.

Budget Comparison

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Current Status: Slightly over budget due to unforeseen expenses related to IT support and online training module development.

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Projected Budget: Overall budget is manageable, with adjustments made to accommodate necessary expenses while maintaining financial feasibility.

Summary

The project to effectively manage behavioral and mental health illness on a medical-surgical unit is progressing well, despite some challenges. Key achievements include successful staff training, patient engagement in mental health screenings, and the integration of a mental health nurse practitioner. Adjustments have been made to the protocol, timeline, and budget to address unexpected events and logistical challenges. Ongoing evaluations suggest positive outcomes, with improvements in patient care and staff competency. The project remains on track for successful completion, with continuous monitoring and adaptation to ensure its objectives are met.

References

Balestrieri, M., Rucci, P., Amendola, D., Bonizzoni, M., Bonura, S., Callegari, M., … & Berardi, D. (2021). Impact of training in detection and management of depression in primary care: A cluster-randomized trial in Italy.
Journal of Affective Disorders, 278, 726-733.

Foster, K., Roche, M., Delgado, C., Cuzzillo, C., Giandinoto, J.-A., & Furness, T. (2011). Resilience and mental health nursing: An integrative review of international literature.
International Journal of Mental Health Nursing, 18(6), 491-502.

Hanrahan, N. P., Delaney, K. R., & Stuart, G. W. (2010). Psychiatric mental health nursing’s agenda for the future.
Archives of Psychiatric Nursing, 24(1), 62-67.

Happell, B., Platania‐Phung, C., & Scott, D. (2013). Placing physical activity in mental health care: A leadership role for mental health nurses.
International Journal of Mental Health Nursing, 22(5), 362-369.

Kates, N., Mazowita, G., Lemire, F., Jayabarathan, A., Bland, R., Selby, P., … & Audet, D. (2011). The evolution of collaborative mental health care in Canada: A shared vision for the future.
Canadian Journal of Psychiatry, 56(5), 1-10.

Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure.
Journal of General Internal Medicine, 16(9), 606-613.

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7.
Archives of Internal Medicine, 166(10), 1092-1097.