Graduation Semester and Year

2016

Language

English

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Monee Carter

Abstract

Background: Second-generation antipsychotics (SGAs), the mainstay of treatment for persons with serious mental illnesses (SMI), have been linked to obesity and metabolic syndrome. There is an urgent need for providers to adhere to clinically applicable guidelines for screening and monitoring metabolic disturbances in this population. 2 Methods: A randomized retrospective chart review of 60 patient records, one group pre-test data without a comparison group was performed following initiation of SGAs, 6 months before the intervention. This was repeated after a 3-month intervention which involved implementation of a recommended schedule for metabolic monitoring. The intervention included provision of monitoring equipment (weighing scales, blood pressure cuffs), repetitive communication using reminders and prompts among all stakeholders, and embedding a collaborative milieu within the team structure. Results: There was significant improvement in provider adherence rate in screening and monitoring of earmarked metabolic indices during initiation and ongoing use of SGA therapy. There was a mean score of 2.07 and 4.58 in the pre and post-intervention stages, respectively. Patients in the post-intervention period were more likely to have anthropometric measurements of weight (BMI), blood pressure, and blood panels. This difference remained significant when narrowed into individual indices that were monitored. Conclusion: Implementation and use of a metabolic monitoring schedule in an outpatient psychiatric clinic for patients treated with SGAs led to significant improvement in adherence rates among psychiatric providers. However, rates remain invariably low, underlining a need for focused strategies and collaborative approaches to further improve metabolic monitoring.

Disciplines

Medicine and Health Sciences | Nursing

Comments

Degree granted by The University of Texas at Arlington

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Nursing Commons

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