Date of Award

Fall 2019

Project Type

Clinical Doctorate

College or School




Program or Major

Doctorate of Nursing Practice

Degree Name


First Advisor

Margaret Shepard

Second Advisor

Amanda Garcia



The two largest counties within Southwest Florida (SWFL) are Lee and Collier where mental health evaluations for children under the state’s Baker Act have more than doubled between 2011 and 2017 (Gluck & Zeitlin, 2019, p. 4). Given the marked increase in mental health evaluations, early recognition, assessment with initiation of treatment by nurses in the pediatric emergency department (ED) who present with behavioral health complaints must be a priority for emergency department leaders. Purpose: This quality improvement (QI) project proposed to improve a nurses’ self-efficacy through expanding knowledge in the recognition and identification of the signs and symptoms of patients in a mental health crisis. Method: All eligible ED nurses completed the Mental Health First Aid Youth (MHFAY) course and the MHFAY pre and post quiz as part of the mandatory department education. A pre and post self-efficacy questionnaire was completed by the nurses participating in the project post-intervention. Participants were asked to complete a qualitative debriefing questionnaire to gather data regarding the nurses’ feelings and emotions about their self-efficacy in caring for a patient in a mental health crisis. The information was collected using open-ended questions. Data Analysis: Quantitative and qualitative descriptive analysis was performed. Descriptive, simple statistics, including Mean (M), Standard Deviation (SD), were used to assess how the overall participants performed on the pre and post intervention and self-efficacy questionnaires. Qualitative data was absent due to the lack of response to this portion of the project by any of the participants during the timeframe given for this portion of the project. Project Relevance: There is a lack of mental health literacy and self-efficacy of nurses to recognize and identify the signs and symptoms to adequately provide early care, treatment and necessary medications to stabilize a patient during a mental health crisis. An evaluation of the educational program was used to determine the effectiveness in the expansion of the nurses’ mental health literacy.