Date of Completion

Summer 8-6-2024

Document Type

Open Access Project

Degree Name

Doctor of Nursing Practice (DNP)

Faculty Advisor

Joanne Roman Jones

Site Advisor

Victor Petreca

Second Reader

Edith Barrett

Abstract

Abstract

Description of the Problem: Insomnia significantly impacts mental and physical well-being, with long-term health effects and considerable healthcare costs. While pharmacological treatments offer temporary relief for some, they do not always provide lasting solutions.

Available Knowledge: A PRISMA-guided literature review found that training programs for cognitive-behavioral therapy for insomnia (CBT-I) are effective in increasing knowledge and confidence for addressing impaired sleep.

Aim and Objectives: This project aimed to enhance mental health clinicians' ability to assess and treat impaired sleep, focusing on implementing a tailored CBT-I educational initiative in a correctional facility.

Intervention: This project implemented evidence-based CBT-I training for mental health clinicians at a Boston correctional facility to address sleep issues among incarcerated adults. Pre-assessments and final surveys gauged clinicians' confidence and knowledge in CBT-I, while bi-weekly huddles gathered feedback on training effectiveness.

Evaluation of Intervention: The output measures included data from frequency and proportion of mental health clinicians who participated in a face-to-face training, who participated in bi-weekly huddles, who showed an increase in knowledge and confidence and survey results completed by the mental health clinicians about feasibility, applicability, and value added.

Results: The project ran from August 2023 to March 2024. Initially, all eight clinicians began training, but only five remained. Bi-weekly feedback huddles had participation rates ranging from 50% to 88%. Although 63% reported increased knowledge and confidence, it did not meet the 85% target. Participants had varied perceptions of the initiative's value, feasibility, and applicability, indicating mixed feedback.

Discussion: This project aimed to enhance mental health clinicians' skills in addressing impaired sleep among incarcerated individuals through a tailored CBT-I program. Clinicians reported increased knowledge and confidence over weeks 4, 8, and 12. Feedback indicated that 73% found the project valuable, 60% found it feasible, and 53% saw its relevance in correctional settings, with no negative responses. The project supports the use of Orem's theory when considering non-pharmacological interventions in correctional sleep care, demonstrating CBT's effectiveness in managing sleep issues.

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