Enhancing Mental Health Competencies in Advanced Practice Nursing Graduates

Sunday, 30 July 2017: 8:30 AM

Nancy E. Edwards, PhD, MSN, ANP-BC
School of Nursing, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
Susan J. Kersey, MSN, PMHCNS-BC
School of Nursing, Purdue University, West Lafayette, IN, USA

Purpose: The purpose of this project was to assess the impact of a curricular enhancement of mental health content to Adult Gerontology Primary Care Nurse Practitioner students. The project goal was to demonstrate the influence of this enhanced curricular content on graduating NP students’ perceived competence and confidence in providing care for patients with basic mental health concerns in the primary care setting.

Methods: A gap analysis was conducted to determine the mental health content that needed to be integrated into the curriculum. The content was determined by comparing the current curriculum with the 2013 NONPF Population- Focused Nurse Practitioner Competencies- Psychiatric Mental Health. Content was added to the didactic portion (from 6-18 hours), through progressive interactive case studies led by a psychiatric Mental Health CNS, and with clinical integration (30 hours) with psychiatric mental health professionals. A pre-test /post-test evaluation was conducted using a written questionnaire to assess the graduating NPs perceived competence in the knowledge of psychoactive medications and in the treatment of mental health conditions that frequently present to mental health clinics. The questionnaire was given at the completion of their first year, before any clinical or specialty content and again at the completion of their second year, prior to graduation.

Results: The sample included 45 students who completed the Master’s of Science Nurse Practitioner at a Midwestern State University between the years of 2013 through 2016. The students (4 male and 41 female) were enrolled in the Adult Gerontology Primary Care Nurse Practitioner program. A significant difference was noted between the pre-test and post test scores in the graduates reported comfort in providing care for individuals with mental health conditions. The students reported a significant increase in their comfort in providing care for individuals who presented to primary care with depression, depression resistant to 1 medication, anxiety, ADD/ADHD and Bipolar disorder. No significant difference was noted in comfort with providing care for individuals with Obsessive compulsive disorder, Victims of domestic violence, addiction, eating disorders and schizophrenia. In relation to psychotropic medications, a significant difference was noted in their comfort in prescribing SSRIs, SNRIs, Norepinephrine-Dopamine Reuptake inhibitors, Antianxiety medications (Benzodiazepines) and ADHD medications. No difference was noted in the reported comfort in atypical antipsychotics and norepinephrine-specific Reuptake inhibitors

Conclusion: Enhancing students exposure and experience in handling mental health concerns through the use of progressive mental health case studies, enhanced didactic content and clinical exposure led to an increase in perceived competence and confidence in the graduates ability to handle many common mental health concerns that often present to the primary healthcare setting. In addition, the graduates were able to identify and appropriately refer individuals with mental health conditions they were not comfortable treating. The graduates also reported increased confidence in ordering medications used to treat common mental health conditions. With the shortage of mental healthcare providers, primary care providers including NPs are called upon to provide increasing mental health