NURS FPX 9904 Assessment 3 Doctoral Project

Project Summary Report

NURS FPX 9904 Assessment 3 Several emotional issues can arise and progress to become even more severe, thus there is need to prevent them from happening in the first place. The project brief report is meant to address a gap that has seen people fail to access importance mental health services that they need. The QI goal of this project is to increase patient engagement in online CBT at UCS Psychiatric Institute by providing patients’ access to the internet to attend therapy meetings (Shih et al. , 202<). The goal of the project is to use the remote technology to increase the actual people attendance to the CBT classes. The potential benefits resulting of the project are increased number of patients attending the video CBT classes and improved competencies among the nurse staff. The following plan recommends the gap analysis structure as well as other components needed to support the QI project including miscellaneous potential problems where the WFAQIP framework would be applicable.

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Background and Organization Gap Analysis

Counseling is essential in healthcare, and regardless of the mental health issue, it is crucial to take a client to the doctor as early as possible. However, certain factors characterize barriers that hinder folks from accessing Mental Health services when they require them most damaging, their health . Individuals suffering from mental health difficulties can access CBT lessons in a face to face setting at the study site; this is with an aim of improving their status (Mr. M. S, Personal Interview, October, 17th 2023). A total of 28. 75 percent of the patients admit that distance is a significant problem with receiving any mental health treatment. One of the challenges is that barriers that are physical present inevitable challenges to the endurability of people’s presence at the hospital.

Thus, it implies that we have to search for the best measure to increase the health of the patients. NURS FPX 9904 Assessment 3 qualified mental nurses who occupy such positions as the head of a shift, charge nurse or team leader are allowed to do CBT in a bid to promote their patients’ health. Psycho education, encompassing of various nursing interventions, was conducted by the nurses on a once a week, 45 minutes to an hour. In this aspect of the project, the search for and the engagement of appropriate treatments for each patient in a bid to improve the attendance rate of the CBT sessions was undertaken. When those mental nurses come to understand the significance of telehealth, they are able to offer their sufferers CBT. They assist in lowering the statistics of the new and prevalent absences that have been confirmed in the health sector.

NURS FPX 9904 Assessment 3 Personal Communication

Feedbacks, from the project site, indicated that the clinic has been investing in enhancing its personnel’s knowledge so as to enhance the care it offers to its patients. But employing video during Covid-19, which is essentially brief, rise the number of patients who appeared for CBT, from 23% before Covid to 30% in 2020 (Dr. C. F. , Personal Communication, October 17, 2023) Here again, there notable rise but it must be noted that the increase come with the use of video which it briefly during the Covid-19 regime. Hence, it has been proposed that organization of a CBT lesson through telehealth shall be another best practice for telehealth nursing and has now included the lesson in the organized nursing practice in the project area.

McCall et al. (2021) noted that telehealth-based CBT sessions hold some benefits in the following ways. This was evidenced by numbers indicating respondents who had online cognitive behavioural therapy CBT had 20% less observable manifestations of worry and sadness. Mental health services use the telehealth case where health care workers can conduct treatment sessions online (Harris et al. , 2021), which aids in getting the sessions in on time. I observed that Appendix A contained a lot of information about the root cause analysis. Later to diagnose the DMAIC tool it formulated the problem as the practice gap.

Significance of the Practice Problem

This was the PICOT question that was made for the project: Present Practice (C): How does up-take differ for online cognitive behavioral therapy (I) compared to present practice of Psychiatric Nurses (S). before 10T weeks from now We need to mention the issue of the so-called unexpected treatment; it is high time to underline that mental health can be significantly improved with mental assistance at the proper time. The society fails to diagnose mental illnesses at early stages and those diagnosed are easily dismissed, ignored or stigmatized, access to health care services is also greatly limited. This makes them highly vulnerable to diseases that can be lethal at times. For instance, a research conducted with US adults revealed that about 20% of them encounter mental health issues in any given year, as indicated in the National Institute of Mental Health database. The situation with the cases presented in the field of mental health proves that the project site requires improvement or it should be provided with higher standards.

NURS FPX 9904 Assessment 3 most effective way to assist individuals with mental health issues is by offering telehealth cognitive behavioral therapies to support safety and quality of services provided. Integrated health inaction indicates that left untreated, mental health problems negatively impact the person experiencing these issues, as well as their family and the healthcare system (Singh et al. , 2022). This is a way of showing that although a patient requires certain mental health services for their welfare as well as for the relationship between them and their family, the physical barriers prevent them from receiving such services. Similarly, individuals with informal mental health manifestations amount to approximately $4. 2 billion a year with Taylor making mention that the issue has not received any solution as of the year 2023. Demography demonstrated their better or worsening state of health associated with their general financial strength. It also as much stressed that it pointed out the relevance of demonstrating how the rate of attendance in CBT sessions can be altered.

The primary aim of the given project was to attempt at enhancing the model of the medical care that can be delivered to patients with mental disorders who reside at a distance, with reference to the change in a patient’s state, if any. Cultural beliefs appear to matter; and, in many languages, with the aid of new technologies, online cognitive behavioral therapy can be administered for persons from practically any cultural origin (Hilty et al. , 2020). Other factors influencing telehealth services include regional and national service regulations peculiar to the healthcare sector and the standard healthcare regulations such as the Health Insurance Portability and Accessibility Act (HIPAA) (VanderWerf et al. , 2021). HIPAA rules ensure that people receive appropriate care by making people adhere to HIPAA set guidelines. Some of the topics to be uncovered in the study will help the student to ensure that the legal and ethical rules have been complied with in the project. Based on this study, other important steps should also be taken to help make sure patients get safe care: The need for informed consent: In cognitive behavioral therapy that is delivered through the internet, there should be proper ways of getting people signed up to consent.

Summary of the Evidence

More often than not only articles were utilized as sources to demonstrate how crucial those suggested treatments were for achieving the goal to minimize the identified practice gap at the site of the project. These peer-reviewed sources have discussed a lot about how much the telehealth technology needed for delivering MH services as well as facilitating people to attend appointments. To address the problem and establish its potentials of providing beneficial solutions, the author highlighted a number of themes including telehealth CBT and patient health outcomes; telehealth CBT and patient adherence. The first telecare the patients received with the help of the introduced telehealth-based cognitive behavioral therapy sessions improved their condition (Bellanti et al. , 2021; McCall et al. , 2021). In this part, Telepsychiatry aided in giving take care of patients who were not in the same geographical territory a safe course. Chun et al. (2020) and Franklin et al. (2023) have noted with more such outlets being promoted, clients get a fast service that addresses their needs, thereby enhancing overall health status.

NURS FPX 9904 Assessment 3 Mental Health Patients

Mental health tele-health caused patients to gain the feeling of being better thereby enhancing health. Due to perceived usefulness, the patient attends the session, and due to this, their health is improved (Cuthbert et al. , 2022; Gehrman et al. , 2020; Mishkind et al. , 2020). The literature search also establishes ways mental health professionals perceive that by embracing online CBT the level of care they offer enhances (Cantor et al. , 2021; Nogami et al. , 2022). Telepsychiatric care services also facilitated enhancement of what exactly they described as clinical work practices for better ease in skill enhancement among the staff and eased nuisances of staff burn out (Cormi et al. , 2021; Connolly, Pecelic, et al. , 2022; Gardner et al. , 2020). Analyzing the findings of existing research, it can be concluded that AE in the form of videos can help to improve people’s health and the quality of their lives (Gehrman et al. , 2020; Nakao et al. , 2021). It will also be pertinent to use technology to handle issues of executing the participation aspect to ensure more people turn up for their CBT session and the overall goal of good health is attained.

Quality Improvement Framework

The writers divided the quality improvement process into four key steps – plan, do, study, and act, collectively referred to as the PDSA. All this was done with the intention of seeking to bring changes in the healthcare facilities. Here are four steps in the framework that may assist you in making amendments to the pointed changes. Introducing the solution-based approach, telemedicine will be incorporated to enhance teaching of CBT lessons. In the first step, a clear goal was set, which is shown below: Bringing in Telehealth CBT is what this particular project entails therefore. Because of this, patients are more likely to follow through with their treatment plans, which leads to better outcomes at the clinic: This is the second one, where modifications are made that are tiny, allowing experts to see the efficiency of the solution that has been planned. In the third wave, data was gathered on patients’ adherence to video conducted CBT including the frequency (Cuthbert et al. , 2022). Last but not the least; the modifications which have to be made to enhance the effectiveness of assistance in the light of the project goals and objectives have been applied for. NURS FPX 9904 Assessment 3 process that was used in this case – PDSA model – was constantly tweaked in a way that would allow for the identification of when it is going to be feasible to enhance particular processes or actions in the future.

The PDSA can be conducted at least three times in order to take into consideration the shifts that occur in the course of the cycles of health care systems – which are indeed mobile. To demonstrate how to look forward as well as manage the new knowledge regarding change in the QI project, PDSA planning framework will be employed (Sutton et al. , 2021). Both telehealth and CBT when provided as a programme bring about radical alterations to the mode of operation at the project facility. In this method, psychiatric nurses used the different forms of video CBT as PDSA cycles that were modified in some regards. Psychiatric nurses also use surveys to determine the number of patient enrollments and their perceived satisfaction regarding the proposed modification. The PDSA cycles proved beneficial in enabling people to make right decision regarding how betterment of various areas of the business in order to facilitate the use of vCBT.

Project Description

In this project, It occurs at Dr. Feldman’s Psychiatry Clinic, which is a business that offers health services for the treatment of mental disorders like CBT face-to-face. There are 50 patients with mental health issues that are using one-to-one CBT as an aspect of the project which emphasizes the operational usage of the project. However, 30% stated it was difficult to get care because of the locality they found themselves in (Dr. C F. , Oral Interview, October 17, 2023). Due to the nature of the work done and type of patients involved, only psychiatric nurse who are qualified will be involved and the other patient will be one with a mental illness. However, it was dealing with working for the group; mental nurses who never had the qualification to do so, for example, were not permitted to be part of the project.

For this reason they also excluded patients who did not want to be a part of the study. The way the new intervention is done through telehealth-based CBT is, in fact, a direct solution to getting more patients to attend the sessions. In every step of transitioning the project into practice, there will be a need for input from professionals in the specialization to design a telehealth site for the requested site, as well as a continuously running program and training for the RN for the TCRS procedure.

NURS FPX 9904 Assessment 3 Intervention Psychiatric

The first and foremost intervention involves psychiatric nurses being able to communicate with the patients through a secured telehealth platform (McCall et al. , 2021). Different points of view can be formed from the following: Since the sites entail communication of the patient’s information, the telehealth sites will adhere to HIPAA regulations. To have safe communication with patients through the Internet, only such telemedicine possibilities that are valid with regard to HIPAA are involved. Raising awareness of the nurse staff; to enable the patient to be treated through tele-CBT is the second step in treating the patient (Harris et al. , 2021).

It also leads to staff making them less helpful with developing tools used for telehealth meetings because they do not get to engage with the technical aspect of managing such meetings as frequently (Graven et al. , 2021). Understanding the functionalities of the telehealth platform as well as understanding how to engage in conversations that foster formation of positive virtual environment is vital for having excellent online meetings as posited by (Graven et al. , 2021). The third process involves the utilisation of clinical procedures that are instituted by experts; such as the Ontario TeleFreq Child and Youth Counseling System in the delivery of CBT lessons through telephones. Measures will enable the correct processes & treatments to be applied to facilitate recovery in mentally ill individuals (Craig et al. , 2021). Due to its composition into three parts, it is possible to apply the same plan in another health care center and increase the health of patients’ minds.

Project Evaluation Results

NURS FPX 9904 Assessment 3 QI project is primarily in the form of video tool to assist with mental health patients to receive cognitive behavioural therapy (CBT) at the Psychiatry Clinic via a remote mode. Looking at the results helps place the suggested solution somewhere and figure out out how well it would perform. The intervention employed internal ways of monitoring; whereby session logs were used to indicate how many times the patient was able to attend the ten weeks of telehealth-based counselling sessions. Telehealth tools can be deemed valuable for mental health care by the right kind of data analysis, right data analysis.

Drawing plans and scaling objects

Both quantitative and qualitative research approaches were adopted to determine the effectiveness of the project in terms of telehealth-based CBT. Engaging in on line CBT lessons as a way of helping take care of patients from a distance , enhances the patients’ health outcomes and attendance within ten weeks. The management obtained approval for the project plan and the means of collecting data from the Institution Review Board, commonly referred to as IRB. In accordance with the aim and objects of the planned project, both qualitative as well as quantitative tools were employed for data collection. Some figures illustrated how many patients came back, the utilization of the video tool by the nurse team, and the adherence to the TCRS (Hassani et al. , 2021).

NURS FPX 9904 Assessment 3 quantitative data are used mostly to determine what is getting in the way of patients being able to go to the recommended solution while the qualitative data are used more to describe what is preventing the same. Details of the poll and questions applied to the session to look at the session logs and notes of the remote meeting show that the poll and questions were used to acquire qualitative information (Lester et al. , 2020). I thank Dr. Clive Cliff Feldman the instructor for granting us permission to use the internal tool for the project. While acknowledging that some of the internal tools such as session logs may not be highly accurate, establishing inter-observer reliability and validity can assist in obtaining accurate project data (Rule et al. , 2022). Collecting details of the attendance and frequency rate determined before how effective the planned solution would be. The software used for the job is with the private tool labeled as Appendix B.

Evaluation in the Formative

What concerns the selection of the principal change management method of the QI project, it is imperative to mention that an initial review method was employed at this stage, which allowed for implementing the changes, depending on actual needs. NURS FPX 9904 Assessment 3 feedback support improves the exercise of the telehealth-based CBT and thus the project functions effectively (Kirchner et al. , 2022). Besides, it enables early alterations precisely to the technique, which is additionally a benefit of formal evaluation.

Adding to the confusion

NURS FPX 9904 Assessment 3 mentioned earlier, it was useful with the factors that could skew the outcomes, including patients ‘and staffs’ perception of emerging trends in healthcare. Indicators of the effectiveness of the project are outlined by the number of times the patient attends the telehealth-CBT session; efficacy of the nursing staff – their performance and adherence to clinical practice guidelines. As Shih et al. (2023) propose, differences, for example, in points of view and environmental conditions impact the project outcomes. To be able to get the results that are wanted, it is essential to take those complicating factors into consideration.


For this particular study, the descriptive data concept was adopted. When using data prior and post change, it is proper to use numbers and amount (Li et al. , 2021). Numbers were tuned to find out the level of success in the three objectives of the project that include; attendance of the patients, the skill level of the nurse team, and adherence to the clinical protocol. Based on this study, before the given intervention, the participants’ data was collected and ten weeks after the intervention data were also collected.  

Discussion and Implication for (State Profession) and Health Care

Unsurprisingly, it takes a good planning to sustain a new business after completing a doctoral project. The continuous process of evaluation and integration into practice has a significant impact on the individuals who are working in the mental health setting and are involved in the provision of care. On this way, telehealth can help to make the process of delivering health care more favorable for those who work in this field, such as trained mental nurses. The authors of this article: McCain et al. think that the application of video to upgrade the hospital processes might be effective in retaining staff and enhancing staff satisfaction. Establishing procedural measures and guidelines for Video Meetings also increases the level of care within the healthcare business (Anderson & Singh, 2021). People can be less resistant about changes if they discuss it with others and incorporate ideas in the process of working. Shih et al. claim that patient feedback assists in eradicating concerns and makes the people more inclined to continue with telehealth-based CBT sessions, as cited in 2023. An increase in the quality, effectiveness or sophistication of services enables health care providers to cultivate confidence among the patients, and hence greater patronage and increased revenue levels.

In order to enhance the efficiency of the utilisation of the tele-health instruments in mental health later on after the intervention, they require constant training as well as supervision. Continual assessment, and update of the changes that require some more extended time to implement within the health care group are achievable, According to Singh et al. , 2022. The first positive outcomes introduced the possibilities of applying telemedicine technology for further intervention in the sphere of mental health and supported the assumption to employ it even more in the sphere of healthcare. Additional studies are underway, to determine outcomes concerning practice of extended duration of internet-based CBT on patient outcomes, engagement, and mental well-being recovery.

NURS FPX 9904 Assessment 3, investigating how patient culture influences the outcomes and well-being of the patient within a virtual environment may also increase the utility of technology within the context of healthcare practice (Farrer et al. , 2022). To continue this flow of change in hospital situations we need to consider the financial impacts Similarly the negative impacts of change since the financial aspects are mainly positive. Creswell, Minnesota’s approach of performing a full cost-benefit analysis is useful for determining the cost of maintaining VCBT. Taylor et al. (2023) discovered that mental ailments that are not finite امتیazu socioeconomic lose the global community $4. 2 billion every year. Less hurry and flutter require hospital visits or inpatient stay when a quick response from a doctor is available through telehealth. This could in the long run help to cut on the costs of taking mental health issues since they will have been diagnosed early.

Summary and Conclusion

In NURS FPX 9904 Assessment 3 QI project embarked on the use of video technology to ensure that the number of patients who reported for their appointments was higher. The project is best managed with the aid of a good quality improvement model such as plan, do, study and act or PDCA. The first step to explore the data was to use descriptive statistics, therefore, diagnostics of the analyses were hopeful. By evaluating the project, it was clear that there was 90% increased uptake of patients coming for the CBT lessons and therefore can be regarded as a success. Regarding mental health care, the knowledge of the nursing team adopting the telehealth technology was one of the strengths and its success rate was above the expected 95% successful video meeting. Similarly, the predicted percentage of 90% is also realized if normal methods are applied in a video CBT.

The poll results also indicated that the opponents’ personal observations of the performance of the nursing team revealed the gain in skills. A number of things have been recommended as follows; Patients should be observed frequently to make sure they retain high retention rates. While it is crucial to assess the effectiveness of interventions, the primary purpose of data collection and analysis will be to evaluate the sustainability of positive outcomes in the long term. To the points made by the project, the continuation of improved patient attendance and review and the maintenance of the skill level of the nurse team was insisted on.

There were also concerns equally raised by the results that called for improved long-term compliance to treatment processes. This will make it better since the intended telehealth-based CBT intervention is planned to be given to patients and nurse professionals, where obtaining detailed comments from both categories regarding the service is possible. This will provide the researcher with relevant information of the intervention to be used in the study. In the future, researchers will apply a randomized controlled trial study for a comparative evaluation of the strategy by comparing results from a group receiving it with results from a group not receiving it.


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