Date of Conferral



Doctor of Nursing Practice (DNP)




Cynthia Fletcher


AbstractElderly patients admitted to psychiatric units are a vulnerable population, some may have mental disorders, physical decline, cognitive challenges; along with other comorbidities in addition to their mental illness. However, their physical health needs may be overlooked due to the presenting behaviors mimicking mental health behaviors. The nurses working in the local hospital facility’s geri-psych unit failed to recognize signs and symptoms of physical decline in their severely mentally ill (SMI) patients. Not recognizing and reporting acute changes resulted in patients’ prolonged hospitalization, decreased quality of life, and increased cost to the facility. The purpose of this DNP project was to develop an education program to increase nurses’ knowledge of, and ability to recognize, early signs of physical decline in hospitalized SMI patients and to implement prompt interventions. The education program was presented to seven nurses who worked on the facility’s geri-psych unit. The nurses completed a pretest before the program and a posttest after the program. Descriptive statistics were used to determine the difference between the pre- and posttests. The aggregate mean score was higher in the posttest, indicating that the nurses’ knowledge increased after participating in the program. One recommendation included reinforcing to nurses during staff meetings the importance of recognizing early signs and symptoms of declining physical health so that they are better prepared to implement prompt interventions to decrease patients’ decline and hospitalization, decrease cost to the facility, and improve patients’ quality of life.