Theses and Dissertations at Montana State University (MSU)
Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/733
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Item Improving the care continuum following discharge from a critical access hospital due to a mental health crisis(Montana State University - Bozeman, College of Nursing, 2022) Truesdell, Melinda Marie; Chairperson, Graduate Committee: Yoshiko Yamashita ColcloughData shows that in the first week post-discharge from the hospital following a psychiatric crisis, a person is 300 times more likely than the general population to die by suicide (Chung et al., 2019). Access to outpatient mental health treatment in the week following discharge from the hospital due crisis is an evidence-based intervention measured by the National Committee of Quality Assurance (NCQA) that saves lives. Rural populations have an additional risk of death by suicide due to multiple factors that limit mental health care access. Engaging patients while they are at the hospital with a mental health specialist and scheduling an appointment for outpatient mental health treatment are essential bridges in the mental health care continuum. This DNP project highlights a workflow process in which the hospital peer support specialist communicates with an outpatient mental health clinic crisis care coordinator about patients in need of post-discharge services following a mental health crisis. Through this interdisciplinary process, patients were provided with an outpatient appointment within seven days following hospitalization. The DNP student tracked appointments made for and kept by patients following hospitalization. Although the results were too small for meaningful analysis, lessons learned provide valuable experience for future mental health care coordination quality improvement projects. Limitations include a short six-week implementation timespan and COVID-related influences.Item Postpartum depression screening and treatment in a rural setting : an evidence based policy(Montana State University - Bozeman, College of Nursing, 2014) Truesdell, Melinda Marie; Chairperson, Graduate Committee: Kathleen SchachmanDespite years of research and discussion surrounding the impact of postpartum depression, it continues to be under diagnosed and under treated. Many women believe they are failing to handle the stress of motherhood and are embarrassed to seek help. Women living in rural communities have the added pressure of limited access to services and embarrassment related to a lack of anonymity that accompanies living in a small town. Equally important to successfully addressing this pervasive mental health issue is education and engagement of clinicians who provide the bulk of care for expectant mothers and their families. The purpose of this project is to develop a policy utilizing evidence-based screening and interventions which can be initiated during prenatal office and subsequent follow up visits during the first year postpartum.