Preceptor and Staff Empowerment: A Quality Improvement Project

There is an ever-growing need for youth mental health services in the state of Utah. The problem begins with the disparity that 40% of Utah's youth suffering from depression did not receive treatment (Summers, Meppen, & Ball, 2019). Subsequently, the overall national, non-population specific utilization of inpatient mental health services increased 6% in one year, from 2016 to 2017 (Summers, Meppen, & Ball, 2019) and Medicaid reimbursement for youth behavioral services doubled between the year 2000 and 2010, (Boat et al., 2016). As the inpatient setting utilizes nurses to assess, plan and implement care, as well as other non-licensed clinical nursing staff, it is essential to note that nurses do not specialize in pediatric or psychiatric care within their academic training programs, (Boat et al., 2016). Training of clinical professionals may be varied across disciplines and may be dependent on the level of experience caring for the particular population (Carter, Latif, Callaghan, & Manning, 2018). Moreover, nurses with a pediatric background reported feeling inadequately prepared to manage care for youth exhibiting challenging behaviors, leading to a regressive behavior in the nursing staff of emotional distress (Foster, 2009). These matters risk impacting patients and staff alike, especially in the case of caring for the "difficult patient" or patients that are "hard to empathize with" (Caruso et al., 2013). Caring for these patients is often associated with poor outcomes such as clinical team splitting, extended hospitalizations, and difficulties with therapeutic relationship and outcomes in addition to staff burnout ( Caruso et al., 2013). Similar issues impact two adolescent units at a 120-bed inpatient mental health hospital, experience comparable complaints to which adolescent core staff and float staff retain the expectation to gain competency in the specialty that requires adolescent-specific, unique safety procedures and policies. A lack of knowledge or skills in implementing these policies often has the effect of staff splitting, which disrupts the milieu. Therefore, a pragmatic solution includes a quality improvement project refining the training and preparedness of clinical staff, through adequate orientation and resources. The purpose of this project is to supply resources to empower and provide training to prepare clinical staff for the challenges of the adolescent mental health units. Nurses receive formal training in nursing programs to which they gain exposure to mental health, pediatricclinical rotations, and growth and development courses, but do not specialize in specific populations (Boat et al., 2016). Even though the facility promotes the national behavioral healthnursing certification, this excludes non-licensed clinical nursing staff, such as psychiatric technicians, and is not specific to adolescent mental health. Furthermore, the facility's currentmodel of training is unstructured, and mentors without preparation in the form of preceptor classes or certification. Therefore, equipping the facility with a mentor base through a preceptor program has the opportunity to enrich staff empowerment and strengthen development, as the possible results include the improvement of nursing satisfaction and retention (Arabi, Johnson, Forgrave, 2017)