Matching Items (2)
- All Subjects: Mindfulness
- Creators: Imanatue, Loveline
- Creators: Pierce, Albert
- Member of: Doctor of Nursing Practice (DNP) Final Projects
- Resource Type: Text
- Status: Published
Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?
The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.
Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.
Aim: To investigate the feasibility and efficacy of mindfulness as an intervention in reducing burnout and promoting joy in work for progressive care unit (PCU) nurses and nursing aides. Background: The Institute for Healthcare Improvement (IHI) describes a lack of joy in work and the resultant burnout as a serious threat to healthcare workers and organizations. Few studies have examined this phenomenon in PCU nurses and aides. Method: Pre- and post-intervention surveys with established instruments on three variables, mindfulness, burnout, and joy in work, were administered to ten PCU nurses and aides (N = 7) at a city hospital. The intervention was the virtual IHI's mindfulness course and was guided by Martin Seligman's PERMA Model and the Iowa Model for Evidenced Based Practice. A paired sample t-test was used to evaluate changes in the pre-post survey responses. Results: Significant increase in joy in work based on an alpha value of 0.05, p = .041. Slight increase in mindfulness practice based on an alpha value of 0.05, p = .398. Burnout remained the same based on an alpha value of 0.05, p = .766. Conclusion: PCU nurses and aides who practiced mindfulness for 12 weeks scored the same on burnout scales and higher on the joy in work scales. Implications for Nursing Management: Nurse managers can incorporate mindfulness exercises at strategic times during the shift to reduce burnout and promote joy in work for nurses and aides. Future EBP projects should assess the effectiveness of different mindfulness activities in promoting nurses' emotional and psychological well-being in various care settings.