Now showing items 1-6 of 6
Treating Depression and Sleep Impairment to Improve Pain Levels and Quality of Life for Patients with Sickle Cell Disease: A Quality Improvement Project
Background: Vaso-occlusive crisis (VOC) pain is both an acute and chronic factor for patients with sickle cell disease (SCD). Acute, recurrent, and unrelenting pain is often joined by other affective disorders that impact pain chronicity, and some patients with sickle cell disease have depression and/or sleep disturbances that may impact pain levels and quality of life. Aim: The purpose of this quality improvement project is to improve the process of assessment and treatment of depression and sleep disturbance in patients admitted to Bridgeport Hospital, Bridgeport, CT with VOC. The goal of this project is to improve overall pain levels and quality of life for patients with SCD through efficient and effective evaluation and treatment for depression and sleep disturbance. Method: An interdisciplinary team, led by the palliative care (PC) advance practice registered nurse (APRN), used the Stetler Model to guide the process of translating existing research regarding the impact of depression and sleep impairment on pain and quality of life in patients presenting with VOC, into evidence-based practice. The team created the Guideline for the Evaluation and Treatment of Depression and Sleep Impairment in Sickle Cell Disease. Patients were assessed, offered treatments and reassessed during the project period. Results: Both depression and QOL scores showed significant improvement by the end of the project. Significant correlations were found between pain, depression and sleep; depression, pain, sleep and QOL; sleep, pain, and depression; and QOL and depression. Patient admissions as well as average length of stay decreased over the course of the project. Limitations: The small convenience sample size limits the generalizability of the results to other practice sites. Patients who were not readmitted during the project timeframe were lost to follow-up, and were not reassessed to determine the effects of treatment recommended by the guideline. Conclusions: Interdisciplinary teams are effective in creating a guideline to assess and treat depression and sleep impairment and their effects on pain and QOL in patients with SCD. Implications for Practice: PC APRNs provide support and symptom management to patients with life-limiting and serious illnesses, including patients with SCD, as a means of improving QOL. This project has significance for APRNs in both palliative care and specialty SCD/Hematology care as a means to translate existing research into evidence-based practice; as well as provide an efficient and effective means to evaluate and treat depression and sleep impairment and their impact on pain and quality of life....
IV Ketamine Infusions for the Treatment of Depression: An Evidence Based Practice Analysis
According to the World Health Organization, major depressive disorder (MDD) is a mental health condition which affects a significant portion of the worldwide population and is projected to become the leading cause of ...
Chronic Pain: Relationship to Depression
The experience of chronic pain often interferes with family and social life, work performance, and overall quality of life. Depression symptoms in people with chronic pain may synergistically effect pain perception, ...
Testosterone Replacement in Symptomatic Men: Assessing Knowledge, Barriers, and Prescribing Habits of Nurse Practitioners
Purpose: Approximately 13 million men suffer with low testosterone, reporting symptoms of fatigue, decreased libido, erectile dysfunction (ED), and depression. Despite the published benefits of testosterone therapy, less ...
Implementation of Depression Screening to Optimize Chronic Pain Management
Background: Chronic pain affects millions of people worldwide and the evidence demonstrates prevalent co morbidity of chronic pain and psychological issues such as anxiety, insomnia, and depression. The existence of ...
Identifying Depression in Primary Care: An Evidence-Based Intervention
Identifying depression in primary care is an urgent concern locally and nationally. Due to lack of screening or inquiry by primary care providers, as well as an insufficient number of mental health professionals, depression remains under-detected. This problem has been identified locally as a result of a 2014 population health survey in Huron County, Ohio. The population reported multiple reasons for not seeking out a program or service within the county to address symptoms of depression, anxiety, or emotional problems. The 2016 recommendation by The United States Preventative Services Task Force is to screen the general public as long as there are resources to provide appropriate treatment. Providers should assess risk factors with the patient by discussing the results of the screen and to decide necessary care such as investigating causative factors, monitoring symptoms, pharmacotherapy, and/or referral to mental health professionals. The purpose of this evidence-based practice improvement project was to add to the knowledge of depression screening by evaluating for patient satisfaction of the newly implemented two-step method in a primary care practice in an effort to improve depression identification. The Rosswurm and Larrabee updated version of the Model for Evidence-Based Practice Change was used to guide the project. In a primary care practice setting, patient satisfaction of a new two-step screening method was assessed over a two-week period of time using a six-question satisfaction survey administered to participants chosen by simple randomization. Of the participants (n=86), nearly all (n=84) were satisfied with the new method....