Kinstler, Daniel Paul

Background Cardiovascular disease is linked to mental health conditions. Patients with cardiovascular disease and comorbid psychiatric illnesses such as major depressive disorder or generalized anxiety disorder often experience greater physical limitations and decreased overall health. Objective To determine if proactive psychiatric interventions improve staff satisfaction and patient outcomes, such as reducing length of stay and decreasing the 30-day readmission rate, for patients hospitalized on cardiac units with psychiatric comorbidities. Methods The implementation of a proactive psychiatric consultation-liaison service, which included proactive screening of psychiatric needs among patients hospitalized on cardiac units, targeted support for cardiovascular staff, and supportive interactions for patients. Results Comparison between preintervention and postintervention periods indicated a 21% reduction in the 30-day readmission rate for patients hospitalized on cardiac inpatient units with psychiatric comorbidities without adversely affecting hospital length of stay. Staff satisfaction significantly increased with the availability of psychiatric resources. Conclusion The implementation of a multi-disciplinary proactive psychiatric consultation-liaison service on inpatient cardiac units was associated with an increase in cardiovascular staff satisfaction with psychiatric services and a decrease in the 30-day readmission rate of patients with psychiatric comorbidities who were hospitalized for cardiovascular services without significantly affecting length of stay.

Purpose: The current quality improvement project aimed to improve functionality within a psychiatric consult liaison nurse (PCLN) service through implementation of an educational pathway. Method: Pre- and postintervention qualitative interviews were conducted with eight PCLNs, and themes were generated via content analysis. Quantitative surveys were also conducted, and data were analyzed using means and standard deviations. Paired t tests were used to test for significance. Results: Qualitative results identified five themes: Flexibility vs. Uncertainty , Ambiguity vs. Direction , Structured vs. Unstructured Education , Efficiency/Time Management , and Communication . Quantitative surveys indicated the intervention improved the consistency of the psychoeducation provided ( p = 0.03) and enhanced the structure of the PCLN role ( p = 0.04). The intervention did not significantly improve communication between PCLNs and medical–surgical nurses. Conclusion: Qualitative findings showed that the educational pathway improved efficiency, time management, and communication, and quantitative findings showed it can help with consistency and structure to the role. Implementing an educational pathway for PCLNs is feasible and effective for health care systems.