Nursing nursing dnp- 896 assignment

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Scholarly Project Proposal

6 PAGES EXCLUDING ABSTRACT, TITLE PAGE, AND REFERENCE 

PLEASE USE THE ATTACHED RUBRIC TO COMPLETE THE ASSIGNMENT

For this proposal, you MUST include an ABSTRACT and A CONCLUSION.

ID Problem and Clinical The problem is how does the use of “Ask Suicide Screening Question” toolkit (I) as compared to not using the “Ask Suicide Screening Question” toolkit (C) affect referral to behavioral health team (O) within 3 months of the visit (T)? 

PICOT-(P) Amongst nurses providing health visits to homebound patients (I) how does the use of “Ask Suicide Screening Question” toolkit (I) as compared to not using the “Ask Suicide Screening Question” toolkit (C) affect referral to behavioral health team (O) within 3 months of the visit (T)? 

PLEASE SEE FULL DETAILS ATTACHED

PLEASE FOLLOW THE RUBRIC TO COMPLETE THE ASSIGNMENT

SOME ARTICLES ATTACHED, PLEASE USE THE ARTICLES AND 4 -6 MORE OTHER ARTICLES

Northern Kentucky University

Doctor of Nursing Practice Program

DNP 896 Rubric Scholarly Project Proposal


DNP Project Proposal DNP 896 II

5-6 Typed written pages not including title page and reference list; chosen journal format

Possible Points

Points Received

1. Title page

5

Includes title page in the format of the chosen journal

5 points

Missing items in title page in the format of the chosen journal

3 points

Missing title page

0 Points

1. Identification of problem and clinical PICOT question 1-2 paragraphs

10

Identifies and explains the clinical problem and the lists the PICO question.

9-10 points

Missing information in the identify-

cation and ex- planation of the clinical problem

1-8 points

Lacks discussion of the clinical problem.

0 points

1. Clinical significance to advance practice nursing 1-2 paragraphs

10

Discusses the clinical significance of the identified problem.

9-10 points

Incomplete discussion of the clinical significance of the identified problem.

1-8 points

Lacks discussion of the clinical significance of the problem.

0 points.

1. Review of the literature -2 page synthesis of representative literature

15

In two pages writes a succinct synthesis of key concepts of the representative literature related to the identified problem.

13-15 points

Incomplete synthesis of the representative literature of the identified program.

3-12 points

Missing the synthesis of the literature; writes individual articles summaries rather that a synthesis of key concepts.

0- 2 points

1. Theoretical framework 1 paragraph

10

In one paragraph describes theoretical framework or project implementation model that supports the DNP project.

9- 10 points

Missing key points of the framework including how the model or framework supports the project.

2-8 points

Missing the framework or model and or missing how

DNP Scholarly Project Plan

School of Nursing, Northern Kentucky University

DNP 806: Program Development, Implementation, & Evaluation

2

DNP SCHOLARLY PROJECT PLAN

DNP Scholarly Project Plan

The research component of a Doctor of Nursing Practice (DNP) degree is a clinical investigation designed to improve patient outcomes. This document describes the project strategy for using the “Ask Suicide Screening Question (ASQ)” toolbox for evaluating self-harming behavior, depression and suicidal thoughts in patients confined to their homes. The Plan for the project is outlined as follows: evidence-based practice (EBP) incorporation, observable results, important players, a SWOT analysis, cost benefit analysis, tools and techniques, and cultural and educational factors.

Program Overview and Incorporation of Evidence Based Practice

The project plan purpose is to create a program that will utilize the ASQ toolkit to assess home-based patients’ symptoms of depression, thoughts of self-harm and suicide. Niculescun et al. (2021) found that patients who are unable to leave their homes due to their illness or disability may experience feelings of helplessness, hopelessness, loss of confidence, other depression symptoms including suicidal ideation due to their circumstances. Adults who are confined to their homes have a higher symptom load than their community-dwelling counterparts, with more severe pain, more frequent episodes of dyspnea, and considerable impairments in their ability to do daily activities (Ankuda et al., 2022; Men et al., 2021). These patients have been found to be disproportionately affected by depression, particularly the elderly. Niculescun et al. (2021) reports depression is highly prevalent in this population, with nine to thirty percent of all homecare recipients reporting some symptom of depression. Ultimately, one in two homecare recipients may be at risk of clinical depression, highlighting the importance of depression screening in this context (Xiang et al., 2018)

Measurable Program Goals and Outcomes

Among patients requiring health care visits (P), how does use of the “Ask Suicide Screening Question” toolkit (I) as compared to not using the “Ask Suicide Screening Question” toolkit (C) affect self-harm behavior and suicide (O) within 3 months of the visit (T)? The target population is home-based patients. The independent variable is the Ask Suicide Screening Question toolkit, while the dependent variables are self-harm behavior and suicide within 3 months of the visit.

Measurable Program Goal and Outcome #1: Reduction in depressive symptoms

Depression in Homebound Older Adults: Recent Advances in
Screening and Psychosocial Interventions

Namkee G. Choi, PhD1, Jo Anne Sirey, PhD2, and Martha L. Bruce, PhD, MPH3

1The University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, Austin, TX
78712; [email protected]; 512-232-9590; 512-471-9600 (fax)
2Department of Psychiatry, Westchester Division, Weill Cornell Medical College, 21 Bloomingdale
Road, White Plains, NY 10605; [email protected]; 914-997-4333; 914-682-6979 (fax)
3Department of Psychiatry, Westchester Division, Weill Cornell Medical College, 21 Bloomingdale
Road, White Plains, NY 10605; [email protected]; 914-997-5977

Abstract
Homebound older adults are more likely than their ambulatory peers to suffer from depression.
Unfortunately, the effectiveness of antidepressant medications alone in such cases is limited.
Greater benefits might be realized if patients received both pharmacotherapy and psychotherapy to
enhance their skills to cope with their multiple chronic medical conditions, isolation, and mobility
impairment; however, referrals to specialty mental health services seldom succeed due to
inaccessibility, shortage of geriatric mental health providers, and cost. Since a large proportion of
homebound older adults receive case management and other services from aging services network
agencies, the integration of mental health services into these agencies is likely to be cost-efficient
and effective. This review summarizes recent advances in home-based assessment and
psychosocial treatment of depression in homebound recipients of aging services.

Keywords
Homebound older adults; chronic illness; mobility impairment; mental health; depression;
depression screening; psychosocial intervention; evidence-based psychotherapy; antidepressant
medication; Older Americans Act; aging service settings; in-home services; PHQ-9; BSI-18;
cognitive impairment; problem-solving therapy; telehealth delivery; behavioral activation;
PEARLS; Healthy IDEAS; problem adaptation therapy; Beat the Blues

Introduction
Despite projections that overall disability rates in later life will continue to decline [1,2], the
rapid growth of the older-adult population is likely to increase the number of homebound
older adults who require in-home support services for their physical, functional, and mental
health needs. According to the 2011 U.S. Census data, of 40 million noninstitutionalized
adults age 65 years and older, 9.2 million (23.5%) had ambulatory disability and 6.2 million
(15.8%) had indep

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THE ROLE OF THE HOME HEALTH NURSE

360 Volume 34 | Number 7 www.homehealthcarenow.org

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Carla J. Groh, PhD, PMHNP-BC, FAAN, and Manuel S. Dumlao, MD

based depression interventions and mental health

outcomes. Bao et al. (2014) conducted a qualita-

tive study based on semistructured interviews

with nurses and administrators from five home

healthcare agencies in five states (N = 20) focused

on Medicare policies. The researchers reported

that several Medicare policies are misaligned with

the need to improve depression care and are at

odds with evidence-based depression care and

the chronic nature of depression. For example,

Bao et al. found that Medicare’s homebound and

“skilled” need eligibility criteria limited the nurses’

ability to follow-up with depressed patients for a

sufficient time. Although depression assessment is

included on the Start-of-Care (SOC) Outcome and

Assessment Information Set (OASIS-C1), follow-up

assessment for depression in OASIS-C1 is lacking

on several fronts: there is no follow-up assessment

in OASIS-C1 during the 60-day episode, nor is it

included in the OASIS-C1 at resumption of care

after hospitalization, recertification for another 60-

day episode, transfer to an inpatient setting, or at

discharge. Moreover, Bao et al. noted that vendor-

developed electronic health records do not support

depression care in home-based services.

Other gaps and barriers identified in the litera-

ture revolve around how home healthcare nurses

view their role in relation to depression care. A

study conducted by Bao et al. (2015) reported that

home healthcare nurses (1) did not consider de-

pression care to be within their scope of practice;

(2) reported a sense of low self-efficacy in address-

ing depression and engaging patients in depression

care; (3) had misconceptions about the relationship

between depression and the aging process (e.g.,

de

1.
ID of Problem and PICOT Questions

2. Identification of problem and clinical PICOT question 1-2 paragraphs

(P) Amongst nurses providing health visits to homebound patients (I) how does the use of “Ask Suicide Screening Question” toolkit (I) as compared to not using the “Ask Suicide Screening Question” toolkit (C) affect referral to behavioral health team  (O) within 3 months of the visit (T)?

Identification of problem

Depression is more prevalent among homebound patients versus non-homebound patients. Specifically, 12-16% of older home health care patients suffer from depressive disorders, however, depression is often not well screened or treated among older home health patients because of reasons such as stigma against depression (Kim et al, 2019).

Niculescun et al. (2021) found that patients who are unable to leave their homes due to their illness or disability may experience feelings of helplessness, hopelessness, loss of confidence, other depression symptoms including suicidal ideation due to their circumstances.

Several studies were reviewed, demonstrating the importance of suicide screening in this population and the efficacy of the ASQ toolkit in identifying people at risk of suicide.

(
Copied from previously submitted course work)

2.
Clinical Significance

Clinical significance to advance practice nursing 1-2 paragraphs.

Home healthcare clinicians are well positioned to drive this effort for improving depression care with

enhanced learning. Thus, the purpose of this article is to provide guidelines on improving

depression care in homebound older adults based on four clinical functions central to home

healthcare: screening, assessment, medication management, and patient/family education. this is a direct quote from article attached below.

3 Review of the Literature

Review of the literature -2 page synthesis of representative literature

Review of Literature

The comprehensive search process involved using crucial databases such as CINAHL, Cochrane Library, and PubMed. The search was limited to articles published in less than five years (2019 to 2023). The search terms included self-harm, home-based patients, suicide screening, screening, prevention, instrument validation, and the Ask Suicide Screening Question toolkit. Consequently, a total of 16 relevant articles were retrieved. Eight were considered important after a thorough review of the most relevant articles.

The Importance of the Suicide Screening in Home-based Patients

The home-based clients are considered at high risk for suicide because of the isolation. In addition, many of these individuals also suffer from chronic diseases and disabilities. Suicide screening is

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