Publication Date

Spring 2015

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Lynn Van Hofwegen

Second Advisor

Marie Foland

Third Advisor

Jan Sampson


Confidence, Competence, Nursing needs


Mental health patients often suffer from chronic medical conditions and psychiatric comorbidities requiring frequent emergency, primary care, and acute care visits (Douzenis et al., 2012). Caring for psychiatric patients in acute care hospitals has become an increasing burden on healthcare systems with processes in place to care for acute and critical care patients. Healthcare leaders, providers, emergency departments, and medical/surgical hospitals are straining to provide care for complex patients with acute medical conditions and complex mental health needs (Reiss-Brennan, Briot, Savitz, Cannon, & Staheli, 2010). Caring for children and adolescents with medical and psychiatric problems creates the need for a structured, evidence-based plan as well as systems to provide the safest environment for these children to heal. This project created a Patient Care Standard based on a nursing needs assessment to provide a structured plan of care to utilize available resources and identify opportunities for future quality service line improvements.

The Model for Improvement was utilized to guide this process. The Model for Improvement is utilized and recommended by the Institute for Healthcare Improvement (IHI) for process improvement. This project highlights the ongoing needs of adolescent mental health patients who are receiving care in medical centers all over the country and the struggle for the healthcare team to meet those needs. This project continues to advocate for the needs of the mental health community as well as the healthcare team who are providing care for them. A Patient Care Standard for pediatric patients receiving care in a non-mental health facility will further define processes and give the healthcare team the tools necessary to advocate for this fragile patient population. Ongoing development of resources and defining the expectations of the mental health practitioners will create a program that comprehensively meets the needs of children, adolescents, healthcare team members, and families.


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