Staff Education for Nurses and providers on Rapid Mood Screener Essay
Staff Education for Nurses and providers on Rapid Mood Screener Essay
Abstract
Advances in the psychiatric field have led to the development of valuable tools that can be used in screening patients to understand their condition better. Indeed, instruments such as Rapid Mood Screener have been significantly used to help diagnose conditions such as bipolar disorder. The implication is that such tools need to be appropriately used by healthcare practitioners such as nurses for better and more accurate diagnostic results. A more accurate diagnosis is a foundation for better patient management and outcomes. Therefore, as part of a bigger plan, mental health facilities should make deliberate efforts to ensure that the nurses and other healthcare professionals involved in mental health patients’ care have access to and are competent in using tools such as the Rapid Mood Screener. The project’s purpose was to focus on education and closing the gap using the staff education module, with an outcome to increase education scores from pre-test to post-test to decrease providers’ errors using the bipolar assessment tool. The Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model and Knowles theory guided the development and implementation of the staff education program for the 12 nurses in the targeted outpatient psychiatric clinic. A pretest/posttest design was implemented to assess the participants’ knowledge before and after receiving the staff education. Descriptive statistics were calculated. The mean test score increased by 28%, indicating a nurse knowledge increase. Training nurses on the effective use of RMS and other screening tools have the potential to develop the ability of nurses to diagnose mentally ill patients effectively. Healthcare facilities should evaluate staff awareness of screening tools gaps and implement relevant interventions to bridge the gaps.
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To my children, always remember that no matter the obstacles you may face in life, never give up or lose hope. Most importantly, continue to see life through God’s lenses alone. A special thank you to both of my parents for their continuous support and unconditional love.
Acknowledgments
Several individuals deserve acknowledgment for their support and role in completing this project. First, I am grateful to God almighty for allowing me to complete this project successfully. I am thankful to my entire family. A special thank you to my children and husband for their prayers and encouragement. I am sincerely grateful to my project committee chair Dr. Francisca Farrar; you are indeed God’s sent; thank you for the support, encouragement, and guidance throughout this project. Thank you to committee member Dr. Janine Everette and URR reviewer Dr. Stoerm Anderson.
Table of Contents
Section 1: Nature of the Project 1
Local Nursing Practice Problem.. 2
The need to address the problem. 3
Significance to Nursing Practice. 3
Nature of the Doctoral Project 5
Contribution to the Nursing Practice. 8
Transferability to Other Practice. 8
The Implication for Social Change. 9
Section 2: Background and Context 12
Concepts, Models, and Theories. 13
Relevance to Nursing Practice. 15
Recommendations and Strategies. 16
Local Background and Context 17
Section 3: Collection and Analysis of Evidence. 22
Section 4: Findings and Recommendations. 27
Strengths and Limitations of the Project 30
Section 5: Dissemination Plan. 31
Appendix A Pre and Post-Test Questionnaire. 39
Appendix B: Facility Stakeholder Formative Review of Education Program.. 40
Appendix C: Program Evaluation. 41
List of Figures
Figure 2. Another Figure Title. 7
List of Tables
Table 1. A Sample Table Showing Correct Formatting. 6
Table 2. Another Sample Table. 6
Section 1: Nature of the Project
Introduction
The role of healthcare professionals in enhancing positive patient outcomes is prominent and forms a central part of the plan of healthcare and patient services (Coster et al.,2018). As such, past and present efforts have been to improve every aspect of patient care through innovations, inventions, and research. One of the areas that have been a problem in patient care is misdiagnosis which has potential harmful impacts on the treatment of patients and their well-being (Stiles et al., 2018). While misdiagnosis can occur in any illness, psychiatric health and illnesses are usually more prone to misdiagnosis due to the screening tools needed to differentiate one disease from the other. Among such conditions is a bipolar disorder which has been associated with premature death, cognitive impairment, functional impairment, and diminished life quality.
Advances in the psychiatric field have led to the development of valuable tools that can be used in screening patients to understand their condition better. Indeed, instruments such as Rapid Mood Screener have been significantly used to help diagnose conditions such as bipolar disorder (Montano et al., 2021). The implication is that such tools need to be appropriately used by healthcare practitioners such as nurses for better and more accurate diagnostic results. A more accurate diagnosis is a foundation for better patient management and outcomes. Therefore, as part of a bigger plan, mental health facilities should make deliberate efforts to ensure that the nurses and other healthcare professionals involved in mental health patients’ care have access to and are competent in using tools such as the Rapid Mood Screener. Rapid Mood Screener (RMS) is a screening tool developed to assist psychiatrists in differentiating between bipolar one disorder and depressive disorder (Montano et al., 2021). The tool was created by a group of healthcare professionals, including primary care clinicians, behavioral therapists, health economists, and psychiatrists. The tool provides a pragmatic approach for easy and accurate screening of bipolar one disorder.
Local Nursing Practice Problem
Problem Statement
Misdiagnosis is one of the most prominent and common problems that substantially impact patients and public health. Misdiagnosis can lead to various adverse problems, such as misleading the providers to prescribe the wrong drug and formulating an erroneous care and management plan. Such mistakes can easily complicate and worsen a patient’s health, laying the ground for a patient’s death or long-term injury (Cuomo et al.,2021; Mohajan, 2018). As such, it is essential to ensure that the providers and nurses are knowledgeable regarding accurately identifying patients with bipolar disorder and appropriately diagnosing them. Misdiagnosis of bipolar disorder and depressive episodes and symptoms as the major depressive disorder is common in psychiatric health (McIntyre & Calabrese, 2019). Such confusion can be costly in terms of wrong medication prescription and administration; hence, the Rapid Mood Screener is a welcome relief as it enhances the screening of bipolar disorder features and manic symptoms, improving the accuracy of such diagnostic procedures. Better outcomes for patients with mood disorders heavily depend on how accurately the providers can differentiate major depressive disorder from bipolar disorder.
The need to address the problem.
It is worth noting that the RMS is a new scale and is effective in improving the accuracy of mood disorder diagnosis. However, the psychiatric nurses attending to the patients in the outpatient clinics do not apply bipolar assessment scales, causing a gap and need for education. Such a drawback has been connected to the lack of organizational support for current and new evidence-based practice procedures and tools. In addition, some of these providers and nurses lack knowledge of the existence of such scales. Therefore, healthcare organizations must deliberate efforts to eliminate the barrier to the effective use of RMS and other diagnostic tools (McIntyre et al., 2021). Indeed, in cases where the providers can accurately and confidently diagnose patients with bipolar disorder, there are enhanced chances that they would effectively treat such individuals and meet their expected patient health outcomes. As such, this doctoral project explored strategies for enhancing providers’ and nurses’ knowledge in improving practice outcomes.
Significance to Nursing Practice
The project proposed an educational program in the psychiatric care settings, specifically in the outpatient setting, with a major focus on educating nursing staff on how to use rapid mood screeners to identify patients with bipolar disorder appropriately. Such a step is significant to ensure patients’ better and timeous care services. The program was successful because the management was corporative. Moreso, patients with bipolar disorder, have the potential to benefit from the program since a more competent staff will offer them care.
The Purpose
As earlier indicated, this project focused on education and closing the gap using the staff education module, with an outcome to increase education scores from pre-test to post-test to decrease providers’ errors using the bipolar assessment tool. As such, this project sought to address questions for nurses and providers caring for mental health patients in an outpatient clinic, will education on rapid mood screening increase their education score to prevent misdiagnosis?
The providers and nurses must be up to date and current regarding evidence-based practice and appropriate tools employed to enhance the chances of accurate diagnosis of bipolar disorder among such patients. In addition, the providers and the nurses must thoroughly understand the adverse effects of mental health patients’ misdiagnosis and the possible dangers connected to patient outcomes (Montano et al., 2021). A successful educational program heavily hinges on the trainer’s level of knowledge of the appropriate information to be taught.
Gap in Practice
The existing practice gap informed the rationale behind the design of this project. The identified practice gap was the lack of awareness among the providers and nurses in the psychiatric outpatient services regarding the application of the rapid mood screener as a tool to assess and screen patients with bipolar disorder to improve accuracy.
Addressing the Gap
The Rapid Mood Screeners have not been used for long and are, therefore, relatively new. The implication is that not every provider is using the tool. However, in recent times, psychiatric healthcare providers are observing and understanding the adverse impacts of misdiagnosing patients with depression instead of correctly diagnosing them with bipolar. The solution to this problem lies in various efforts and initiatives focused on decreasing the chances of misdiagnosis. For example, the providers and the nurses need to understand bipolar disorder’s key symptoms and recognize the dangers of misdiagnosis (Montano et al., 2021). Again, nurses need to know the risk factors and conditions connected to bipolar disorder. Additionally, nurses need to identify and understand the use of resources relevant to diagnosing bipolar disorder as such tools and knowledge are critical in patient accurate and appropriate diagnosis.
Nature of the Doctoral Project
Fulfilling the project’s requirements require that various protocol be followed, such as meeting with the committee chair to explore the topic and narrowing down the focus to select a project that meets the requirements of a DNP staff education module. It has been indicated that the nurses’ and providers’ knowledge would be assessed before and after the intervention making the pre and post-evaluations key. Therefore, descriptive statistics were used in analyzing the collected data. Therefore, through descriptive statistics, the DNP scholar was able to evaluate whether the nurses’ and providers’ knowledge and ability have improved upon using the staff education intervention. The project followed the steps used in implementing the educational module. The steps include planning, implementation, and evaluation.
Sources of Evidence.
A literature review was key to the success of the project. Therefore, a literature review was accomplished using databases accessed through the university. Some of them include Cochrane databases of systematic reviews, The American Journal of Psychiatry, Ovid, ProQuest, PubMed, MEDLINE, CINAHL, and journals by Professional organizations such as CDC using only recent articles of 5 years or less and obtaining appropriate evidence from databases required using keywords related to the project topic. Therefore, the keywords used include bipolar, rapid mood screener, misdiagnosis, and nurse education.
Support the organization in recruiting staff for education. Note that the site, not Walden, oversaw the education program. Hence all recruitment materials reflected that.
The Approach to Project
The following steps were taken to implement the project, verified the staff education program with the organization leadership team and providers via formative, and revised the staff education plan based on the outcome of the formative; the revised educational program plan was then presented to leadership and providers, confirmation of the validity and usability of the project was discussed while using evidence-based resources to implement the staff education program and lastly, finalized the staff education program including anonymous questionnaire review given to both leadership and providers. The assessment offered valuable results to inform the course the educational program took.
The Purpose of the Project
The identified practice gap informed the purpose of the project. The identified gap was the lack of use and knowledge of the Rapid Mood Screener in identifying patients with bipolar disorder. There has been a need to increase nurses’ and providers’ knowledge regarding identifying patients with bipolar disorder without confusing the symptoms with depressive symptoms. The project aimed to carry out a staff education program for nurses and providers on using Rapid Mood Screener to enhance their ability to identify patients with bipolar disorder. Through the project, it was expected that the nurses and providers would minimize or avoid the issue of misdiagnosis.
Significance
Stakeholders
Stakeholders refer to individuals or groups of individuals impacted by the project from initiation and implementation to project closure. As earlier highlighted, this was an educational program for educating nurses and providers on using Rapid Mood Screener to enhance their ability to identify patients with bipolar disorder. Therefore, the identified stakeholders include the patients and their families, the nurses, providers, and hospital leaders. It is important to educate nurses and providers to be knowledgeable about the accurate identification of patients with bipolar disorder, and an educational program can help achieve this goal. Patients are the first stakeholders as they stand to benefit from using the Rapid Mood Screener for better diagnosis and management of the condition. The family members will also benefit because their loved ones will have better outcomes, reducing emotional and financial burdens. The nurse will also benefit from acquiring more knowledge regarding Rapid Mood Screener’s use in identifying patients with bipolar disorder. Such a step also contributes to their professional growth. The hospital organization may also benefit since better care of patients with bipolar disorder will attract more patients to the center.
Contribution to the Nursing Practice
Nursing care and practice always aim to use the best available and current strategies and evidence to offer appropriate patient care (McNelis et al., 2019). The implication is that the profession has to be at par with the current trends to ensure that nurses remain current and updated on the best possible ways of caring for their patients. Moreso, the population treated by the organization is vulnerable and social determinants of health should be considered. Assessing a patient’s social determinants of health is one of the best ways to predict the chance of developing conditions (McIntyre et al.,2021).
Rapid Mood Screener is a relatively new tool for diagnosing bipolar disorder. Therefore, staff education can play a critical role in increasing the nurses’ knowledge, competence, and confidence in screening for bipolar disorder to avoid misdiagnosis. In recent research, Masters et al.(2022) showed that staff training is critical in building staff capacity in various aspects of patient care. On the other hand, these researchers argued that lack of formal education on a particular issue could be a serious barrier to the staff offering patients the needed or expected care. The staff educational program will hugely contribute to nursing practice in screening and managing patients with bipolar disorder.
Transferability to Other Practice
The formulated educational material will be delivered to the psychiatric unit among the nurses and providers. It is hoped that the educational program will effectively improve the nurses’ and providers’ knowledge concerning using the Rapid Mood Screener to identify patients with bipolar disorder. If that is the case, then the formulated educational program can be applied in other areas and conditions in mental health and illness, such as depression, schizophrenia, and anxiety disorders, among others. The educational format can be transferred and used to help improve the screening and diagnosis of such mental health conditions. Given the success of the staff educational program, the curriculum can be integrated into nurse education and competency training to enable them to be knowledgeable regarding the dangers of misdiagnosis and the use of the Rapid Mood Screener. The program can also be used in other disciplines where education and training are required.
The Implication for Social Change
Even though healthcare providers have a primary obligation to offer quality health care and safe patient care to patients, these professionals also have a social obligation to trigger and support positive social change. The primary focus of such a change is to ensure that individuals and groups have healthy lifestyles and focus on applying practices capable of promoting healthy living. Therefore, empowering the providers and nurses to have sufficient knowledge of timeously identifying patients with bipolar disorder will be vital in lowering the financial spending used in caring for these patients, preventing potential health complications, and reducing psychiatric decompensation. Using the educational tool can also lead to the correct patient diagnosis, making them stable and returning to the community. Stability means they can productively and positively contribute to the community and participate in its activities.
In the face of lower healthcare spending in the care of this group of patients, the excess resources that could have been used in the management of bipolar disorder can be diverted into other health complications that also require funding for better patient outcomes. Walden University is focused on formulating mission-driven change. Therefore, this project aligns with Walden’s mission and supports its goal of enhancing social change. The project also aimed to improve the lives of the populations and communities it serves and focuses on promoting their lives in the future. The providers and psychiatric nurses need to influence the populations they serve positively. Therefore, such an educational program has made them more knowledgeable, proficient, and confident in offering such care.
Summary
Nursing evidence-based and quality improvement projects are key in addressing clinical and patient care problems that derail adequate care provision and potentially lead to adverse patient outcomes. Therefore, this DNP project was formulated to help bridge the gap in identifying patients with bipolar disorder, causing misdiagnosis. As such, this DNP project focused on improving the nurses’ and providers’ knowledge regarding using Rapid Mood Screeners to help identify patients with bipolar disorder and improve their care outcomes. The nurses and providers were educated for better understanding from the psychiatry department, which deals with bipolar disorder patient care. Apart from the approvals from the Institutional Review Boards of the University and the healthcare facility, a comprehensive literature review was undertaken to obtain appropriate evidence. The project is expected to continue to have a social impact through improved health of the population. it is hoped that it will continue to positively impact nursing practice by offering appropriate education to the nurses to help equip them with the most current knowledge on the use of Rapid Mood Screener to help identify patients with bipolar disorder.
Section 2: Background and Context
Introduction
According to Shen et al. (2018), misdiagnosis is a common clinical and patient care problem and can be an untimely, inconclusive, and incorrect diagnosis. In addition, bipolar disorder is commonly misdiagnosed, especially when it is at the onset. Indeed, misdiagnosis of the condition has had a soaring rate as high as sixty-nine percent. Such misdiagnosis implies that the providers offer the wrong treatment and management plans, resulting in various adverse outcomes and even death. Therefore, the DNP project focused on answering the question as to whether offering staff education to nurses and providers on the use of Rapid Mood Screeners would improve the provider and nurses’ ability and knowledge to identify patients with bipolar disorder. The educational program formulated in this project has helped address the need for training nurses and providers in the psychiatric department.
The project was implemented as part of the plan at a psychiatric outpatient clinic where patients with various mental health concerns or issues get the necessary mental health services without extending their hospital stay. The nursing staff working in the clinic usually apply strategies to foster patients’ ability to cope with stressful situations and events when managing their mental health. The clinic serves approximately ninety patients daily. The clinic has various staff, including three mental health technicians, eight Advanced Nurse Practitioners, four nurses, and an office manager. As such, twelve nursing staff participated in the project. An assessment of the manager’s and the lead clinician’s willingness to support the project revealed that they both support such quality improvement educational projects. An evaluation of the project’s objectives and scope indicates that the project can successfully be accomplished in the chosen setting. The main targeted groups are the nurse and providers available at the outpatient clinic. However, other individuals caring for patients with bipolar disorder were invited. Patients with bipolar disorder are also targeted in the project as the project will significantly affect them. In addition, the facility also had sufficient training rooms to support the proposed educational training program. Lastly, theories and models or frameworks are key in nursing project implementation. Therefore, this section also focuses on the concepts, models, and theories.
Concepts, Models, and Theories
Models and theories form an important part of learning and research. Therefore, a model was incorporated as part of the plan to help guide the staff education program. The ADDIE model was chosen as the instructional design, which includes the following steps analysis, design, development, implementation, and evaluation (Patel et al., 2018). The strength of this model lies in the fact that it uses five major components to help facilitators guide the learners on a path of developing the required skills and knowledge. The five components include analysis, design, development, implementation, and evaluation. The model was also used in formulating the staff education program on Rapid Mood Screener to help the staff address the inadequacy in identifying patients with bipolar disorders. Previous research shows that when ADDIE is used as the model in an educational program, there are higher chances of optimized learning. The ADDIE model has five significant steps: analysis, design, development, implementation, and evaluation. In the analysis phase, the possible factors behind a research or performance gap are inadequacy in identifying patients with bipolar disorder. Design entails verification of the testing and performances. In the development stage, learning resources are generated and validated, followed by an implementation that involves making the learning environment ready and engaging the learners. The final phase entails assessing the quality of the instructional strategy and the processes used. A comparison before and after implementation is accomplished in this stage. Indeed, this was the focus of this project since the nurses and the providers need to have the ability to accurately identify patients with bipolar disorder without confusing the fundamental symptoms with depressive symptoms and avoid misdiagnosis.
Knowles’ andragogy, also known as adult learners’ theory, was used to guide this project. Knowles’s theory emphasizes on unique learning styles of adults in comparison to children. While highlighting the following as an integral part of adult learning, self-concept, past learning experience, readiness to learn, practical reasons to learn, and driven by internal motivation (Learning Theories, 2020). It affirms that adults have already developed their self-concept and knowledge that shapes their learning. At the same time, past learning experiences are valuable as they can be used readily when needed. It is said that; Adult learners place a high value on education and exercise the readiness, motivation, and commitment to stay focused on the task.
Definitions
This project regarding using the Rapid Mood Screener is associated with various terms that need to be defined and understood. The terms include:
- Rapid Mood screener- A screening instrument that uses easy-to-understand terminology to help screen bipolar disorder (McIntyre et al.,2021).
- Bipolar disorder- a mental condition associated with extreme mood swings in the form of depression and hypomania or mania
- Misdiagnosis- Incorrect diagnosis of a patient’s condition.
- Screening tool- A tool used during a mental health examination to help diagnose the mental illness or condition
- Major Depressive Disorder-A mental health condition associated with a bit of interest in activities and constant depressed mood.
Relevance to Nursing Practice
The need to offer the best patient care services to the patients and ensure that the patients are safe in the care environment requires that the health professionals such as nurses are up to date and current regarding the most appropriate and evidence-supported care strategies for patients (McNelis et al., 2019). Therefore, education plays a critical role, especially in an ongoing educational program incorporating current care trends. As such, the provision of the educational program was important in ensuring that the nurses have the most current knowledge regarding the use of and importance of the Rapid Mood Screener. As such, the educational program was formulated and aligned to address the lack of knowledge among nurses and providers regarding the use of Rapid Mood Disorders. The project is relevant to social determinants of health. For example, the education offered to the nurses will enable them to explore the social determinant of health related to bipolar disorder patients, such as social support networks. Such knowledge improves the nurses’ ability to screen patients with the disorder.
Knowledge Deficit
Accurate identification of patients with bipolar disorder, especially in the early stages, is challenging as practitioners are more likely to arrive at depression as the diagnosis (Tomasik et al., 2021). However, with tools such as Rapid Mood Screener, the accuracy of identifying patients with bipolar disorder can substantially improve. However, nurses and providers either do not use the tool or have limited knowledge. Therefore, the educational program focused on how to use the tool and encouraged the nurses and providers to use the tool.
Recommendations and Strategies
This Doctor of Nursing Practice project focused on addressing the gap between knowledge and nursing practice concerning identifying patients with bipolar disorder prone to misdiagnosis. Therefore, the staff education program focused on training and educating the nursing staff and providers on using Rapid Mood Screener to identify patients with bipolar disorder. As such, the project focused on addressing the insufficient knowledge regarding using Rapid Mood Screener and the potential unwillingness among the nurses and providers to use the tool.
Local Background and Context
Summary Of Evidence
Education is key in the patient care setting and nursing profession to keep the nurses up to date. Therefore, the educational program is usually applied to help the nursing staff to engage in better professional practices that improve patient outcomes. The project educated nurses and providers on the purpose and benefits of using a rapid mood screener in identifying bipolar diagnoses. The project was carried out in a psychiatric outpatient clinic. Here, patients receive mental health services without extended stays. The clinic treats about 90 patients daily and has one office nurse manager, two nurses, 10 Advanced Nurse Practitioners, and three mental health technicians; Therefore, there was a total of 12 nursing staff included in this project; misdiagnosis is a common problem in patient care. It is common in identifying patients with bipolar disorder as they are erroneously diagnosed with major depressive disorder. As such, the use of the Rapid Mood Screener can be of great help in the accurate identification of these patients (Tomasik et al., 2021). However, staff education for providers and nursing staff was needed to improve the ability to identify patients with bipolar disorders using the Rapid Mood Screener. Therefore, this project played an important role in improving the nurses’ and the providers’ ability to identify patients with bipolar disorder and reduce the chances of misdiagnosis.
Role of the DNP
As a DNP student, I had a significant role as a project manager to oversee the projects, developing the education module and its implementation, and synthesizing literature and data analysis to ensure the project’s success. One of the major roles in utilizing the ADDIE model was to formulate the educational module and program for the nurses and the providers working in the facility’s psychiatric unit. The educational material developed focused on improving nurses’ and providers’ knowledge and ability to accurately identify patients with bipolar disorder using Rapid Mood Screener. I was responsible for obtaining the nurses’ and providers’ pre- and post-knowledge scores by conducting surveys. I also assisted in facilitating the educational program by training the nurses and providers on appropriately identifying patients with bipolar disorder using Rapid Mood Screener. Therefore, I prominently participated in improving the nurses’ and providers’ assessment abilities by acting as a leader, which is part of DNP essentials (Menonna-Quinn, 2019). As earlier indicated, the project aimed to improve nurses’ and providers’ ability to identify patients with bipolar disorder. By designing the strategies for achieving such a goal, indications are that as a DNP-prepared nurse, I have developed appropriate skills to search for appropriate solutions, choose the right ones and appropriately implement them to help improve patient outcomes and individuals’ and community health outcomes. Such skills also align with the DNP Essentials, especially essential number seven.
My interest in mental health, especially bipolar disorder, was triggered some years ago; due to an encounter with a seventeen years old boy who suffered from trauma. The boy used to have periods of intense depression symptoms and tearfulness, even months after a psychiatrist and counselor started treating her and managing her symptoms. Through years of consistent and persistent management, the young boy was managed by a local psychiatric clinic healthcare professional, who finally diagnosed her with bipolar disorder after completing an assessment and using a rapid mood screener to identify his diagnosis. Since then, I have developed a passion for becoming a psychiatric or mental health expert, more so to ensure that I utilize tools that will assist in the proper diagnosis of bipolar disorder. Furthermore, having watched and read about the struggles and suffering patients with bipolar disorder undergo, I was motivated to explore strategies for improving these patients’ outcomes, hence the rationale behind this project. The proposed staff education program was key in building the nurses’ and providers’ capacity to accurately identify patients with bipolar disorder for better management and treatment strategies and improved patient outcomes.
Role of the Project Team
The success of a proposed project partially depends on the nature of the project team and the amount of effort put in by various project team members (Grove & Gray, 2018). The project team performs various roles, such as providing input on the education module, serve on the expert panel, take the content survey and hand off to the director for sustainability. While the nurses completed the pre and post–test exams, approve the findings, and participated in the hand of the final results. Therefore, as the project leader, it was important to identify team members who helped drive the project to successful completion and implementation. In most cases, the project team works best through inter-professional collaboration. Therefore, the inter-professional project team members were advanced practice registered nurses, providers, and doctors working in the psychiatric department. Other project team members include the lead clinician at the facility and the facility manager.
The facility manager approved the practice site, final findings, and recommendations to accept the handoff while supporting safe and efficient patient care. Therefore, through the manager, it was easier to make the nurses and other staff members support the project and appropriately participate in it. The doctors and psychiatric mental health nurse practitioners played a key role in the project as they collaborated with the DNP-prepared student in several aspects; the key among them was the formulation of the educational program for the nursing staff. It is worth noting that these team members combined their efforts with the lead clinician and the facility manager to effectively influence the nursing staff to participate in the project and support its implementation. The services of a nurse educator were needed to help formulate the best methods to be applied in teaching the nursing staff using the formulated educational content.
Partnerships and collaboration were crucial aspects of the project implementation. For example, the DNP scholar partnered with the curriculum development specialist, while the facility leadership also partnered with the nurses offering care to the patients with bipolar disorders to attend all the training and educational sessions to enable them to understand and better identify the patients with bipolar disorder. The expert panel also played a significant role in approving the content developed throughout the project. For example, the expert panel needed to approve the educational module to educate the nurses.
The project team members provided background information, evidence, and other vital information. As such, a blended form of communication strategies was applied. For example, while in some instances, physical meetings were held, in other cases, zoom meetings were conducted to help relay information. In addition, communication was accomplished through other means, such as email, to let the team members know the project’s progress, what was expected, and if they were a need to adjust the timelines. The proposed timeline for the project was six weeks.
Summary
This write-up section of the project has offered a comprehensive background concerning the project. In particular, the motivation behind the formulation of the project and the reasons for the project have all been explored. The model for formulating the educational program (ADDIE model) has also been identified and comprehensively discussed in terms of how important it was in improving the nurses’ and the provider’s ability and knowledge regarding using Rapid Mood Screener in identifying patients with bipolar disorders. Besides, the role of the DNP student and the project team in the whole project has all been explored. Collecting sufficient data to help evaluate the program’s efficacy was essential. As such, the following section focuses on the practice-focused question, sources of evidence, and analysis and synthesis.
Section 3: Collection and Analysis of Evidence
Introduction
Collecting and analyzing the evidence was key in addressing the practice-focused questions. Using aggregate data analysis, participants were given an anonymous consent form and a code to match the pre and post-test. The data is stored in a locked drawer for the security of their tests and findings for seven years. The evidence showed the importance of using educational programs to improve nurses’ and providers’ abilities, skills, and knowledge to offer better care to patients. The collection and analysis of the evidence also show the impact of early and timely identification of patients with bipolar disorder. Therefore, obtaining relevant evidence appropriate for the practice-focused question was key. Expert panel survey Likert Scale was used in creating the pre and post-test surveys for data analysis and suggestive descriptive; however, to maintain anonymity and to match the pre and post-test, a code was assigned to each individual. Descriptive statistics were employed in evaluating the pre and post-test because it has strong reliability and validity in assessing the educational modules’ weaknesses and strengths.
Misdiagnosis can lead to various adverse problems, such as misleading the providers to prescribe the wrong drug and formulating an erroneous care and management plan. Such mistakes can easily complicate and worsen a patient’s health, laying the ground for a patient’s death or long-term injury (Cuomo et al.,2021; Mohajan, 2018). As such, it is important to ensure that the providers and nurses are knowledgeable regarding accurately identifying patients with bipolar disorder and appropriately diagnosing them. The purpose of this section of the doctoral project is to discuss sources of evidence and research methodology utilized in addressing the misdiagnosis of bipolar disorder. This education program was implemented at an outpatient psychiatric clinic.
Misdiagnosis is common in identifying patients with bipolar disorder as they are erroneously diagnosed with major depressive disorder. As such, the use of the Rapid Mood Screener can be of great help in the accurate identification of these patients. However, staff education for providers and nursing staff was needed to improve the ability to identify patients with bipolar disorders using the Rapid Mood Screener. Education is key in the patient care setting and nursing profession to keep the nurses with up-to-date information regarding patient care (Aebersold et al., 2018). Therefore, the educational program is usually applied to help the nursing staff to engage in better professional practices that improve patient outcomes. The education was offered in sessions that ran for 50 minutes. The expert panel approved the curriculum; as such, the content was appropriate for effective education. Again, the staff work schedule was accommodated; the training was conducted on a Thursday afternoon when the staff was done with the day’s work. The education was conducted using PowerPoint presentation slides. The pre and post-test analysis utilized descriptive analysis, with hand, off, of the findings provided to the managers.
Sources of Evidence
Addressing the practice-focused question required that appropriate sources of evidence be obtained. Therefore, a review of the literature was accomplished by using databases accessed through the university. Some of them include Cochrane databases of systematic reviews, Ovid, ProQuest, PubMed, MEDLINE, and CINAHL (Grove & Gray, 2018). The collection of articles includes information on articles graded with medical pyramid levels 1 to 4 while using articles using the John Hopkins and put in themes integrating all authors. Obtaining appropriate evidence from databases requires using keywords related to the research topic. Therefore, the keywords used included bipolar, rapid mood screener, misdiagnosis, and nurse education. The article search was limited to literature published within the last five years to ensure that the evidence used is most current.
Recently, McIntyre et al. (2021) conducted research that revealed that an accurate and timeous diagnosis is fundamental to achieving desirable outcomes among patients with depressive and mood disorders. The authors further argued that whenever there is a case of a missed bipolar diagnosis, there is a critical need that goes unmet. In another study, Baldessarini et al. (2020) indicated that improving the health outcomes among patients with mood disorders heavily depends on the first step, which requires an accurate diagnosis which is key in helping the practitioners avoid any confusion with the symptoms associated with major depressive disorder. Therefore, it has been observed that the problem may have numerous negative impacts on the patient’s health if not addressed. As such, solving the issue was a priority as it could substantially lead to improved patient care outcomes in the psychiatric outpatient clinic.
The Participants
It is important to identify the project participants (LoBiondo-Wood et al., 2021). As part of the plan, the project includes twelve nurses and providers working at the psychiatric outpatient clinic. It is important to note that no participant was coerced to participate in the project. The DNP candidate met with the nurses and providers to let the participants know what is expected of them during the project. Apart from obtaining consent in such a meeting, they were also made aware of the goals and objectives of the project.
Procedures
From the sections discussed earlier, it was stated that the targeted intervention entailed educating the nurses and providers on using Rapid Mood Screener to identify patients with mood disorders. The education program was carried out in an accommodative way. Therefore, the training was done after the day’s work. The strategy that was employed in delivering the educational material and content to the participants was a PowerPoint presentation. The presentation was integrated with simulation-based learning to enhance the learning outcomes.
Protections
Protections are an important part of research projects, especially involving human subjects. As such, approvals was obtained from the Institutional Review Boards of the University. In addition, permission was obtained from the facility to allow the staff education project to go ahead. As earlier indicated, participating in this project was wholly voluntary, and various modes of communication was used to notify the participants regarding the project’s focus and scope. Which entail sending messages through email and physical delivery of the documents containing the project’s details. Informed consent was needed from the participants who agree to participate (LoBiondo-Wood et al., 2021). It is expected that no risk was connected to the project’s procedures and taking part in the project as the project sought to enhance nurses’ and providers’ ability to accurately identify patients with bipolar disorder through the use of the Rapid Mood Screener and minimize the chances of bipolar disorder misdiagnosis.
Summary
The third section of this write-up has focused mainly on the implementation process of the proposed educational program to improve nurses’ knowledge and ability to accurately identify patients with bipolar disorder. Therefore, the background information, the practice-focused question, and the gap in practice have all been reviewed. In addition, evidence applied in formulating the educational program and the methods and process of obtaining permissions and consent have all been explored in this section. It is worth noting that the third section marks the end of the proposal part of the project. Section four of the write-up will mainly focus on the implementation. In addition, other aspects of the project, such as data analysis and suggestions for future research based on the current findings, will be made.
Section 4: Findings and Recommendations
Introduction
General nurse training has a significant impact on improving the quality-of-service delivery and safety of patients. Effective training given on RMS enables nurses to make better healthcare choices that eliminate the risk of dealing with risky, mentally ill patients. Lack of training on how to use RMS may result in misdiagnosis, which has been a common healthcare problem. However, psychiatric health and illnesses are usually more prone to misdiagnosis due to the screening tools needed to differentiate one disease from the other. These conditions include cognitive impairment, bipolar and functional impairment. The post-test scores for this project reported an increased understanding of the use of Rapid Mood Screener. This result implies that nurses lacked adequate information on screening tools such as RMS to screen for bipolar disorder.
The purpose of this DNP project was to address the gap in the lack of awareness among the providers and nurses in psychiatric outpatient services regarding the application of the rapid mood screener as a tool to assess and screen patients with bipolar disorder to improve accuracy. The practice-focused question is: Whether offering staff education to nurses and providers on the use of Rapid Mood Screeners would improve the provider and nurses’ ability and knowledge to identify patients with bipolar disorder? The evidence-based staff education program was developed for nurses working in the psychiatric department. A pre-test/post-test design was then given to these nurses through the survey, and the responses were analyzed to understand the knowledge before and after receiving the training. Descriptive statistics and Microsoft Excel were used in analyzing the data.
Findings and Implications
The training program was subjected to nurses and providers on how to use Rapid Mood Screeners to identify patients with mood disorders. The data received on both the pre-test and post-test went through adequate statistical analysis to gain insights about the topic under discussion. This study used descriptive statistics on the excel program as the major analytical tool. The mean pre-test score was 61.7, and the post-test score was 90 (see Table 1). According to the outcome from the descriptive analysis, staff training nurses on how to use Rapid Mood Screeners improved the nurse’s knowledge of the use of these tools.
Table 1 Descriptive statistics
| Statistics | Pre-test score | Posttest score | Difference |
| Mean | 61.6667 | 90 | 28.3333 |
| Median | 60 | 90 | 30 |
| Percentage
Difference |
61.6667 | 90.0000 | |
| Mode | 60 | 100 | 30 |
| Standard Deviation | 15.18406 | 10 | 5.18406 |
| Minimum | 20 | 80 | 60 |
| Maximum | 80 | 100 | 20 |
The study had various limitations that included the timing of the nurses and staff buy-in. The meeting held with the stakeholders proved the interest in training many nurses in the psychiatric unit. However, when speaking to the staff who were to take this training, they were eager to learn but pressed for time. Their busy clinic schedules limited their time to undertake the training program. The psychiatric nurses work 12-hour shifts and have limited time to undertake the training. This program was not a must, and all the agreed nurses were to undertake the program in their free time after work. The busy schedules of these nurses resulted in online training for some who could not find time to attend the training physically.
After the successful training program, the nurses had knowledge of the use of RMS and could be of great help in diagnosing bipolar patients without registering errors. Improve use of screening tools such as RMS has the potential to heighten the quality and safety of patients. Again, it will improve patient satisfaction by improving care for mental conditions that have remained a great problem within the healthcare system. The great potential for positive change starts by equipping the staff with the necessary skills that support their work output, increase patient safety, and overall success of the healthcare organization. This improvement will also have a great effect on the entire community.
Recommendations
The findings from the study show that training psychiatric nurses on the use of screening tool such as RMS increased their knowledge about screening techniques. The training on the use of RMS equipped these nurses with effective skills in handling screening tools when screening patients with bipolar disorder. This improved knowledge among nurses can also potentially improve patient care outcomes. Healthcare management must evaluate the lack of awareness among the providers and nurses in psychiatric outpatient services and implement relevant measures to bridge the gaps. In this view, I recommend the implementation of staff training program on using Rapid Mood Screeners to identify patients with mood disorders.
Misdiagnosis is a common clinical and patient care problem that can be solved by educating nurses and healthcare providers on the use of screening tools. This problem can be an untimely, inconclusive, and incorrect diagnosis caused by human error. Healthcare professionals spend more time with patients implying that the safety of patients greatly lies on the hands of the nurses. Therefore, improved skills among nurses can enhance their ability to assess and diagnose patients effectively. This process must be followed by incorporating staff training programs to improve service delivery.
Strengths and Limitations of the Project
Any project always has its strengths and limitations. The identification of these strengths and limitations allows the researchers to learn effective ways of improvement projects in the future. Conducting research is a continuous process that will happen even in the future. However, it is the role of the current researchers to mention various ways that future researchers could use to improve studies in the coming years. The healthcare facility’s willingness to allow DNP students to undertake their studies on their nurses is one of the main strengths of this study. The facility realized that the reduction in awareness of the use of screening tools among the nurses and healthcare providers has negatively affected the quality of care. The facility is dedicated to improving evidence-based education modules to enhance employee skills.
The second strength of this study is using an evaluation of pre/post-test in calculating the effect of staff education on the use of the screening tools. This method enables the collection of data before and after the intervention. As a result, comparisons were made to determine the effectiveness of the intervention. The application of evidence-based measures also increases the validity of the project.
Despite the mentioned strengths, the study was also limited in a number of ways. For example, decreased participation was a major limiting factor. Participation was voluntary for all interested nurses, but many nurses did not participate. The decreased staff participation affected the sample size that the project had selected. The busy schedules of these nurses were the main problem that affected their participation in the training program. These issues affected the effective training program, which might have affected the ability of the nurses to answer the questionnaires effectively. Future projects should consider increasing the number of participants with regulations on mandatory training to increase participation in such important projects in healthcare. These regulations will increase the number of nurses accessing evidence-based training.
Section 5: Dissemination Plan
Dissemination is the process of relaying the results of the project to the stakeholders. It allows them to review the outcome of the staff education interventions and decide on the way forward regarding the presented findings. These findings will be shared with the hospital management, facility stakeholders, and nurse managers. The staff within the selected organization will receive a staff education presentation. Managers will receive results on their emails. Again, the outpatient clinics within the community would also benefit from reviewing the results and thinking about implementing the EBP in practice. The results as well are shared with the state registered nursing association.
Analysis of Self
I took the leading role in this project by double tasking as the project manager, scholar, and practitioner. Undertaking these roles have been significant in understanding and owning the project. I was able to engage with the stakeholders in the facility to identify the problems at the clinic. I always appreciate working with the patients to realize their problems and how the facility is strained in addressing the highlighted patient concerns. However, this project has enabled me to interact with facility stakeholders in addressing a gap that directly affects patients. As a DNP student, interaction with these stakeholders was part of the learning process as it aids in gathering enough information that assisted me in developing a practice-focused question that has been a pillar in this project. The project has developed my academic writing skills and allowed me to delve much into the causes and solutions of staff-related problems. In taking up the role of project manager, I was able to understand the problem and develop a positive solution to the cited problem. I have been able to remain objective and focused throughout this project and reduced any instances of my personal biases affecting the process. My participation in this project as also develop my skills as a nurse and improve my professional skills as a nurse educator. My professional objective is to come up with other staff training modules that would improve staff awareness in the healthcare setting. I intend to use my effective writing skills to prepare articles that can be submitted to nursing journals for other scholars to read and cite my work in their projects.
The completion of a project is satisfying. However, one faces various challenges that can affect one’s ability to go on with the project. Despite participant selection and participation challenges, the project enabled me to answer my project-focused question. Various challenges faced during the project included a shorter time of implementation. The project implementation and recruitment phases took place in busy months that limited the staff availability for the project. Offering online training in various instances was important in improving participation. As a DNP nurse, developing long and short-term goals for future projects would be important in mitigating the experienced challenges.
Summary
The purpose of this project was to focus on education and closing the gap using the staff education module, with an outcome to increase education scores from pre-test to post-test to decrease providers making errors using the bipolar assessment tool. The primary strategy was to develop efforts and initiatives focused on decreasing the chances of misdiagnosis. The practice-focused question is: Whether offering staff education to nurses and providers on using Rapid Mood Screeners would improve the provider and nurses’ ability and knowledge to identify patients with bipolar disorder?
I used a pre/post-test design in collecting data before and after the intervention. The education intervention project was developed using the current EBP information implemented after approval from Walden University.
The findings showed a mean of 61.7 for the pre-test score and 90 for the post-test score. The analysis of these scores showed a 28% increase after implementing the staff education intervention. The increase in the mean score evident from Table 1 shows that educating healthcare staff increased their knowledge on using Rapid Mood Screeners in screening bipolar patients. In this regard, healthcare managers should always assign their staff to training sessions to develop relevant interventions for bridging the gap.
References
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Appendix A Pre and Post-Test Questionnaire
Appendix B: Facility Stakeholder Formative Review of Education Program
Appendix C: Program Evaluation
Please complete the evaluation below to provide feedback to the presenter. Please rate the following statements on a scale of 1-4, with 1 (one) being “strongly disagree” and 4 (four) being “strongly agree.
BUY A CUSTOM- PAPER HERE ON; Staff Education for Nurses and providers on Rapid Mood Screener Essay
This is your instructions- It is VERY IMPORTANT that you please follow the instructions to ensure you actually address each question of sections 4 & 5 the final two chapters of this paper and ensure to attach the three appendices I have uploaded here. Be sure to update the proposal to address that the education as now been implemented. Add chapters 4& 5 with the the update of the results, abstact et al.
1. One request for edits in the document- define/describe the RMS (and cite) earlier in your work. Be clear that it is a single screening tool, designed for X, designed by Y (in year), and if there is good supporting literature for the strength of the tool, then include that as well. I had to look for that information in ways that could be alleviated fairly early in the paper. (also, there are a few places that you make RMS plural vs. singular. Please double check that if you are doing that it is appropriate for each instance. This is for final paper
2. Please include the abstract and write the abstract and I will write the acknowledgment so leave room for that.
3. Be sure to update your tab of content with the additional stuff that is been added now, I have attached a sample follow exactly and only use the actual paper I am attaching not your own previous edition because I have had to edit this paper a lot so use the recent paper I have attached to continue this paper
4. Attach all the appendix I sent to you appendix a thru C
5. I have re-atatched the DNP project check list this check list is important it has to match, this is why I needed to keep sending it to you to edit because things were missing- Look under section 4& 5 and ensure that every points is discussed and not omitted to address the focus of this last two sections.
Lastly I attached a student sample in case it will be helpful
Please also use the following statics for me for the result and write what you see fit for evalution as it was positive evaluation significant improvement in the education.
Please insert table 1 under your findings and implications
Only descriptive statics was used for this project use figures below and place in a small table to put under findings and implications- make a table of your own that is neat.
Table 1 Descriptive statistics
Statistics Pretest Score Posttest Score Difference
Mean 69.09 90.9091 21.8182
Median mean 60 100 40
Percentage difference69.09 90.9091 31.578
Minimum 40 80 40
Maximum 100 100 0
Pretest score Posttest score Difference Mean 69.0909 90.9091 21.8182 Median 60 100 40 Mean Percentage Difference 69.0909 90.9091 31.57894737 Minimum 40 80 40 Maximum 100 100 0
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