Date of Award

Fall 10-12-2022

Degree Type

Dissertation

Degree Name

DNP Doctor of Nursing Practice

Department

Nursing

Advisor

Maryellen Roberts, DNP

Advisor

Tamara Lipschie, MD

Committee Member

Kate Hinic, DNP

Keywords

nurse navigator, adherence, 30-day readmission, behavioral health, psychiatry, quantum leaders

Abstract

Mental health patients have been notoriously non-adherent with diligent medication conformity, office visit fidelity, candor about side effects, use of illegal substances for self-medication, and truthfulness about co-occurring conditions. This non-adherence makes treatment difficult for psychiatric providers, and all those who participate in the care of patients with mental illness. Patient non-adherence can cause frustration and can lead to provider burnout, which affects patients as well as providers. Also, there are concerning financial implications of excessive time and resources needed to adequately monitor mental health patients. Implications regarding 30- day re-admissions are tantamount to consideration of financial strains put on all parties when mental health patients are not compliant with treatment. Nurse Navigators can help monitor patients and keep them on track with treatment, which benefits all parties. This Quality Improvement Project researched the history of Nurse Navigators in other health care areas and hypothesized that they can also be useful and financially beneficial in Psychiatry/Mental Health. This project reviewed the retrospective data of admissions and 30-day admissions prior to the implementation of a Nurse Navigator and suggests that following patients more closely can aid in preventing redundant and unnecessary admissions. This project resulted in the implementation of a 3-week trial program that employed a Nurse Navigator to assist providers in offering optimal care to patients. This Nurse Navigator assisted in returning patient calls, checking patient labs, giving out samples of psychiatric medications that have been prescribed, calling pharmacies to confirm patients’ adherence with correct medications, following patients on the Clozaril Rems site (which monitors Clozaril/clozapine levels), calling family members when consents were available in the chart, educating and teaching, referring patients for social services and various support organizations, referring patients to collaborating physicians when indicated by the provider, and reminding patients to complete necessary labs. Keywords: Nurse Navigator, adherence, 30-day re-admissions, CMA, Quantum Leaders, Behavioral Health, Mental Health, Psychiatry.

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