NURS 8502 Week 10 Discussion Impact of the Problem

The initial practice problem identified showed that there was a lack of consistent screening for patients with insomnia in the outpatient mental health clinic. I proposed an educational activity where I would educate staff on how to use the Insomnia Severity Index to provide consistent screening across all points of contact in the clinic.  At first, I was planning on checking if the prescriber’s feelings of self-efficacy had grown as a result of the education piece but I realized I needed to step it back a step and find out what their knowledge gap was, to begin with, so I could best assist them with helping patient’s needs. The clinic has weekly staff meetings so at the staff meeting I did a small teaching demonstration and introduced the ISI to the providers of the clinic.  The providers were then to start screening patients at every visit who presented with sleep disturbances.

Lasting Impact

As previously stated in earlier discussions the impact of early intervention for insomnia can decrease the possibility of hospitalizations for patients with comorbid mental health conditions. The hope is that early interventional screening and teaching patients about sleep hygiene can assist patients with having less severe symptoms or lasting effects of insomnia.  Screenings have been secondary prevention levels for nursing and are reliable and provide data for future interventions.  Not all providers at the clinic were nurses so this is a gap in their education. I believe the long last impact will improve practice for prescribers for future patients. The practice change would create awareness of this comorbidity and that would significantly reduce the hospitalization rates of mental health exacerbations due to lack of sleep  (American Academy of Sleep Medicine, 2021).  I think meeting with my preceptor and the clinic staff gave me a better perspective of the challenges that face outpatient providers due to the lack of resources they have available to them.  Lack of knowledge of the use of the screening tool and lack of nonpharmacological means to assist with sleep hygiene were seen as negative for the providers at the clinic.  Now they have access to tools and the education that will assist them and improving their knowledge base hopefully will have a trickle-down effect on their patients and they will have better outcomes due to early intervention and education.

References

American Academy of Sleep Medicine (2021). Sleep Better. Retrieved from https://aasm.org

Chronic Insomnia. What you can do to sleep better. American Sleep Association. (2018). Retrieved from  https://www.aafp.org/afp/2015/1215/p1058-s1.html