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16.10.2023
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week7directionsrw10-16-23.docx
jhnedp_evidence_rating_scale-1.pdf
SynthesisMatrixTable1.docx
SynthesisMatrixTable11.edited12ndassignment1.docx
JHNEBPRESEARCHAppraisal-1.docx

week7directionsrw10-16-23.docx

Week 7

Comments:

Use of levels -John Hopkins table lists them.

The Synthesis Matrix Table provides you the ability to start organizing the literature you have located through your searching of resources. Additionally, it will help you organize information as you approach construction of the literature review section of your project plan. The literature review section frames and provides support for the DNP project.

You should include and fill out all columns and you should have at least five pieces of evidence listed on the matrix table. However, you are welcome to include more than five as you may very well have more than five that you will utilize in your literature review section of your DNP Project prospectus. For QI projects where you have located best/evidence-based practices appropriate to apply to your project’s identified problem, the literature listed should primarily focus on filtered evidence such as reviews; for example - Cochrane, Joanna Briggs Institute, scoping, systematic, integrated, meta-analysis/meta-synthesis, simple literature, clinical practice recommendations and guidelines.

If in your exploration of the literature you have found a dearth of information about best/evidence-based practices that would be appropriate to apply to your identified problem, your project will be developed as an innovation. In this case, your sources will likely be expert opinion or reports of other innovative approaches.

The table should be organized to present and connect the literature to the project.

jhnedp_evidence_rating_scale-1.pdf

JHNEBP EVIDENCE RATING SCALES

SSTTRREENNGGTTHH of the Evidence Level I Experimental study/randomized controlled trial (RCT) or meta analysis of RCT Level II Quasi-experimental study Level III Non-experimental study, qualitative study, or meta-synthesis. Level IV Opinion of nationally recognized experts based on research evidence or expert

consensus panel (systematic review, clinical practice guidelines) Level V Opinion of individual expert based on non-research evidence. (Includes case

studies; literature review; organizational experience e.g., quality improvement and financial data; clinical expertise, or personal experience)

QQUUAALLIITTYY of the Evidence

A High

Research consistent results with sufficient sample size, adequate control, and definitive conclusions; consistent recommendations based on extensive literature review that includes thoughtful reference to scientific evidence.

Summative reviews

well-defined, reproducible search strategies; consistent results with sufficient numbers of well defined studies; criteria-based evaluation of overall scientific strength and quality of included studies; definitive conclusions.

Organizational well-defined methods using a rigorous approach; consistent results with sufficient sample size; use of reliable and valid measures

Expert Opinion expertise is clearly evident B Good Research reasonably consistent results, sufficient sample size, some control, with fairly definitive conclusions;

reasonably consistent recommendations based on fairly comprehensive literature review that includes some reference to scientific evidence

Summative reviews

reasonably thorough and appropriate search; reasonably consistent results with sufficient numbers of well defined studies; evaluation of strengths and limitations of included studies; fairly definitive conclusions.

Organizational Well-defined methods; reasonably consistent results with sufficient numbers; use of reliable and valid measures; reasonably consistent recommendations

Expert Opinion expertise appears to be credible. C Low quality

or major flaws

Research little evidence with inconsistent results, insufficient sample size, conclusions cannot be drawn Summative reviews

undefined, poorly defined, or limited search strategies; insufficient evidence with inconsistent results; conclusions cannot be drawn

Organizational Undefined, or poorly defined methods; insufficient sample size; inconsistent results; undefined, poorly defined or measures that lack adequate reliability or validity

Expert Opinion expertise is not discernable or is dubious. *A study rated an A would be of high quality, whereas, a study rated a C would have major flaws that raise serious questions about the believability of the findings and should be automatically eliminated from consideration.

Newhouse R, Dearholt S, Poe S, Pugh LC, White K. The Johns Hopkins Nursing Evidence-based Practice Rating Scale. 2005. Baltimore, MD,

The Johns Hopkins Hospital; Johns Hopkins University School of Nursing.

SynthesisMatrixTable1.docx

Synthesis Matrix Chart

	Source 1	Source 2	Source 3	Source 4	Source 5
APA Reference Citation
Purpose of the Study/Article
Is this a research study? If it is an experimental research design, list the independent and dependent variables. If research but not experimental design, what is the study design? If this source is not a research study, what type of literature is represented in the resource?
What level of evidence is represented in the resource?
What are the findings/recommendations in this resource that are relevant to your project?
How does this resource support your proposed DNP project?

SynthesisMatrixTable11.edited12ndassignment1.docx

Synthesis Matrix Chart

	Source 1	Source 2	Source 3	Source 4	Source 5
APA Reference Citation	Tesfa, S., Giru, B. W., Bedada, T., & Gela, D. (2021). Mental distress and associated factors among hospitalized medical-surgical adult inpatients in public hospitals, Addis Ababa, Ethiopia, 2020: Cross-sectional study. Psychology Research and Behavior Management, Volume 14, 1235–1243. https://doi.org/10.2147/prbm.s319634	Sveinsdóttir, H., Zoëga, S., Ingadóttir, B., & Blöndal, K. (2020). Symptoms of anxiety and depression in surgical patients at the hospital, 6 weeks and 6 Months post-surgery: A questionnaire study. Nursing Open, 8(1), 210–223. https://doi.org/10.1002/nop2.620	Casida, J. M., Davis, J. E., Zalewski, A., & Yang, J. J. (2018). Night‐time care routine interaction and sleep disruption in adult cardiac surgery. Journal of Clinical Nursing, 27(7–8). https://doi.org/10.1111/jocn.14262	Josephs, C. A., Shaffer, V. O., & Kucera, W. B. (2022). “Impact of mental health on general surgery patients and strategies to improve outcomes. The American SurgeonTM, 89(6), 2636–2643. https://doi.org/10.1177/00031348221109469	Bailey, E. A., “Wirtalla, C., Sharoky, C. E., & Kelz, R. R. (2018). Disparities in operative outcomes in patients with comorbid mental illness. Surgery, 163(4), 667–671. https://doi.org/10.1016/j.surg.2017.09.029
Purpose of the Study/Article	This study aims “to assess the prevalence of mental distress and identify associated factors among hospitalized medical-surgical adult inpatients in public hospitals.	The purpose of this study is to “describe the prevalence of symptoms of anxiety and depression in surgical patients at three-time points: at the hospital post-surgery, 6 weeks post-discharge, and 6 months post-discharge. The study also aims to detect situations and experiences that predict symptoms of anxiety and depression at later time points.	This study aims to explore the influence of NCRIs on night-time sleep effectiveness (NSE) and daytime sleepiness (DSS) in patients in cardiac surgery critical-care and progressive-care units.	This literature review aims to investigate how mental health disorders (MHD) impact the outcomes of general surgery patients and suggest strategies for improvement.	This study aims to evaluate the relationship between mental health comorbidities and surgical outcomes, including prolonged length of stay, in-hospital mortality, and postoperative complications, in patients undergoing common general surgery procedures.
Is this a research study? If it is an experimental research design, list the independent and dependent variables. If research but not experimental design, what is the study design? If this source is not a research study, what type of literature is represented in the resource?	This study is a research with a cross-sectional study design	This is a research study that uses a prospective, explorative two-site follow-up design.	This is a research study that uses an exploratory design	This is not a research study. It is a literature review that analyzes existing research and studies	This is a research study that uses a retrospective cohort design
What level of evidence is represented in the resource?	Lower level of evidence as it is a cross-sectional study	This resource represents moderate evidence, as it uses a prospective study design to examine symptoms of anxiety and depression in surgical patients over time.	This resource represents moderate evidence as it employs an exploratory research design to examine the impact of NCRIs on sleep-related variables.	This literature review represents high level of evidence as it synthesizes information from multiple studies.	Moderate level of evidence
What are the findings/recommendations in this resource that are relevant to your project?	The study found that the prevalence of mental distress among hospitalized medical-surgical adult inpatients in public hospitals was 53.1%. Several factors were significantly associated with mental distress, including marital status, employment status, residence, alcohol use, previous psychiatric illness, and comorbidity.	The study found that a proportion of patients presented with moderate-to-severe anxiety or depression at different time points. It identified various predictors for anxiety and depression, including not feeling rested upon awakening and higher scores on the Hospital Anxiety and Depression Scale (HADS). The findings emphasize the importance of recognizing psychological distress in surgical patients and the potential benefits of good sleep during recovery.	The study found that frequent NCRIs are common in cardiac surgery units, and further research is needed to draw definitive conclusions about their impact on sleep and daytime sleepiness in adult cardiac surgery patients. Only one of the eight NCRIs (postoperative exercises) was significantly related to sleep variables.	Mental health disorders significantly impact surgical outcomes, including increased post-surgical pain, extended hospital stays, complications, readmissions, and mortality, while decreasing wound healing and quality of care. To optimize outcomes, the review suggests integrating more effective perioperative screening tools and interventions, such as artificial intelligence-based tools, cognitive behavioral therapy, virtual reality, pharmacological approaches, and resilience training.	The study found that patients with comorbid mental health diagnoses had a higher risk of prolonged length of stay and increased odds of any complication after adjusting for confounders. The odds of death were slightly lower in the mental health diagnosis cohort. The study suggests that recognizing these disparate outcomes is the first step in understanding how to optimize care for this population.
How does this resource support your proposed DNP project?	This resource provides valuable information about the prevalence of mental distress and its associated factors in a medical-surgical inpatient setting, which is relevant to the project topic on effectively managing behavioral health/mental health illness in a medical-surgical unit.” It highlights the importance of considering these factors when developing strategies for managing mental distress in such patients.	This resource provides valuable insights into the mental health aspects of surgical patients, which is relevant to my proposed project on managing mental health in a medical surgical unit. It highlights the need for early identification and support for patients experiencing symptoms of anxiety and depression during the surgical and postoperative phases.	This research highlights the importance of managing sleep and sleep disruptions in a medical setting, which can indirectly impact the mental well-being of patients. It provides insights into the potential factors affecting the sleep quality of surgical patients, which is a component of behavioral health management in a medical surgical unit.	This resource provides crucial insights into the direct relationship between mental health and surgical outcomes, which is relevant to my project. It suggests practical strategies for addressing mental health concerns in general surgery patients, which can inform my efforts in effectively managing behavioral health/mental health illness in a medical surgical unit.	This resource provides essential insights into the impact of mental health comorbidities on surgical outcomes, emphasizing the need to consider and address mental health in general surgery. It directly supports my project's focus on managing behavioral health/mental health illness in a medical-surgical unit.” It highlights the importance of optimizing care for patients with mental health comorbidities.

week7directionsrw10-16-23.docx

Week 7

Comments:

Use of levels -John Hopkins table lists them.

The table should be organized to present and connect the literature to the project.

jhnedp_evidence_rating_scale-1.pdf

JHNEBP EVIDENCE RATING SCALES

consensus panel (systematic review, clinical practice guidelines) Level V Opinion of individual expert based on non-research evidence. (Includes case

studies; literature review; organizational experience e.g., quality improvement and financial data; clinical expertise, or personal experience)

QQUUAALLIITTYY of the Evidence

A High

Summative reviews

Organizational well-defined methods using a rigorous approach; consistent results with sufficient sample size; use of reliable and valid measures

Expert Opinion expertise is clearly evident B Good Research reasonably consistent results, sufficient sample size, some control, with fairly definitive conclusions;

reasonably consistent recommendations based on fairly comprehensive literature review that includes some reference to scientific evidence

Summative reviews

Organizational Well-defined methods; reasonably consistent results with sufficient numbers; use of reliable and valid measures; reasonably consistent recommendations

Expert Opinion expertise appears to be credible. C Low quality

or major flaws

Research little evidence with inconsistent results, insufficient sample size, conclusions cannot be drawn Summative reviews

undefined, poorly defined, or limited search strategies; insufficient evidence with inconsistent results; conclusions cannot be drawn

Organizational Undefined, or poorly defined methods; insufficient sample size; inconsistent results; undefined, poorly defined or measures that lack adequate reliability or validity

Newhouse R, Dearholt S, Poe S, Pugh LC, White K. The Johns Hopkins Nursing Evidence-based Practice Rating Scale. 2005. Baltimore, MD,

The Johns Hopkins Hospital; Johns Hopkins University School of Nursing.

SynthesisMatrixTable1.docx

Synthesis Matrix Chart

	Source 1	Source 2	Source 3	Source 4	Source 5
APA Reference Citation
Purpose of the Study/Article
Is this a research study? If it is an experimental research design, list the independent and dependent variables. If research but not experimental design, what is the study design? If this source is not a research study, what type of literature is represented in the resource?
What level of evidence is represented in the resource?
What are the findings/recommendations in this resource that are relevant to your project?
How does this resource support your proposed DNP project?

SynthesisMatrixTable11.edited12ndassignment1.docx

Synthesis Matrix Chart

	Source 1	Source 2	Source 3	Source 4	Source 5
APA Reference Citation	Tesfa, S., Giru, B. W., Bedada, T., & Gela, D. (2021). Mental distress and associated factors among hospitalized medical-surgical adult inpatients in public hospitals, Addis Ababa, Ethiopia, 2020: Cross-sectional study. Psychology Research and Behavior Management, Volume 14, 1235–1243. https://doi.org/10.2147/prbm.s319634	Sveinsdóttir, H., Zoëga, S., Ingadóttir, B., & Blöndal, K. (2020). Symptoms of anxiety and depression in surgical patients at the hospital, 6 weeks and 6 Months post-surgery: A questionnaire study. Nursing Open, 8(1), 210–223. https://doi.org/10.1002/nop2.620	Casida, J. M., Davis, J. E., Zalewski, A., & Yang, J. J. (2018). Night‐time care routine interaction and sleep disruption in adult cardiac surgery. Journal of Clinical Nursing, 27(7–8). https://doi.org/10.1111/jocn.14262	Josephs, C. A., Shaffer, V. O., & Kucera, W. B. (2022). “Impact of mental health on general surgery patients and strategies to improve outcomes. The American SurgeonTM, 89(6), 2636–2643. https://doi.org/10.1177/00031348221109469	Bailey, E. A., “Wirtalla, C., Sharoky, C. E., & Kelz, R. R. (2018). Disparities in operative outcomes in patients with comorbid mental illness. Surgery, 163(4), 667–671. https://doi.org/10.1016/j.surg.2017.09.029
Purpose of the Study/Article	This study aims “to assess the prevalence of mental distress and identify associated factors among hospitalized medical-surgical adult inpatients in public hospitals.	The purpose of this study is to “describe the prevalence of symptoms of anxiety and depression in surgical patients at three-time points: at the hospital post-surgery, 6 weeks post-discharge, and 6 months post-discharge. The study also aims to detect situations and experiences that predict symptoms of anxiety and depression at later time points.	This study aims to explore the influence of NCRIs on night-time sleep effectiveness (NSE) and daytime sleepiness (DSS) in patients in cardiac surgery critical-care and progressive-care units.	This literature review aims to investigate how mental health disorders (MHD) impact the outcomes of general surgery patients and suggest strategies for improvement.	This study aims to evaluate the relationship between mental health comorbidities and surgical outcomes, including prolonged length of stay, in-hospital mortality, and postoperative complications, in patients undergoing common general surgery procedures.
Is this a research study? If it is an experimental research design, list the independent and dependent variables. If research but not experimental design, what is the study design? If this source is not a research study, what type of literature is represented in the resource?	This study is a research with a cross-sectional study design	This is a research study that uses a prospective, explorative two-site follow-up design.	This is a research study that uses an exploratory design	This is not a research study. It is a literature review that analyzes existing research and studies	This is a research study that uses a retrospective cohort design
What level of evidence is represented in the resource?	Lower level of evidence as it is a cross-sectional study	This resource represents moderate evidence, as it uses a prospective study design to examine symptoms of anxiety and depression in surgical patients over time.	This resource represents moderate evidence as it employs an exploratory research design to examine the impact of NCRIs on sleep-related variables.	This literature review represents high level of evidence as it synthesizes information from multiple studies.	Moderate level of evidence
What are the findings/recommendations in this resource that are relevant to your project?	The study found that the prevalence of mental distress among hospitalized medical-surgical adult inpatients in public hospitals was 53.1%. Several factors were significantly associated with mental distress, including marital status, employment status, residence, alcohol use, previous psychiatric illness, and comorbidity.	The study found that a proportion of patients presented with moderate-to-severe anxiety or depression at different time points. It identified various predictors for anxiety and depression, including not feeling rested upon awakening and higher scores on the Hospital Anxiety and Depression Scale (HADS). The findings emphasize the importance of recognizing psychological distress in surgical patients and the potential benefits of good sleep during recovery.	The study found that frequent NCRIs are common in cardiac surgery units, and further research is needed to draw definitive conclusions about their impact on sleep and daytime sleepiness in adult cardiac surgery patients. Only one of the eight NCRIs (postoperative exercises) was significantly related to sleep variables.	Mental health disorders significantly impact surgical outcomes, including increased post-surgical pain, extended hospital stays, complications, readmissions, and mortality, while decreasing wound healing and quality of care. To optimize outcomes, the review suggests integrating more effective perioperative screening tools and interventions, such as artificial intelligence-based tools, cognitive behavioral therapy, virtual reality, pharmacological approaches, and resilience training.	The study found that patients with comorbid mental health diagnoses had a higher risk of prolonged length of stay and increased odds of any complication after adjusting for confounders. The odds of death were slightly lower in the mental health diagnosis cohort. The study suggests that recognizing these disparate outcomes is the first step in understanding how to optimize care for this population.
How does this resource support your proposed DNP project?	This resource provides valuable information about the prevalence of mental distress and its associated factors in a medical-surgical inpatient setting, which is relevant to the project topic on effectively managing behavioral health/mental health illness in a medical-surgical unit.” It highlights the importance of considering these factors when developing strategies for managing mental distress in such patients.	This resource provides valuable insights into the mental health aspects of surgical patients, which is relevant to my proposed project on managing mental health in a medical surgical unit. It highlights the need for early identification and support for patients experiencing symptoms of anxiety and depression during the surgical and postoperative phases.	This research highlights the importance of managing sleep and sleep disruptions in a medical setting, which can indirectly impact the mental well-being of patients. It provides insights into the potential factors affecting the sleep quality of surgical patients, which is a component of behavioral health management in a medical surgical unit.	This resource provides crucial insights into the direct relationship between mental health and surgical outcomes, which is relevant to my project. It suggests practical strategies for addressing mental health concerns in general surgery patients, which can inform my efforts in effectively managing behavioral health/mental health illness in a medical surgical unit.	This resource provides essential insights into the impact of mental health comorbidities on surgical outcomes, emphasizing the need to consider and address mental health in general surgery. It directly supports my project's focus on managing behavioral health/mental health illness in a medical-surgical unit.” It highlights the importance of optimizing care for patients with mental health comorbidities.

week7directionsrw10-16-23.docx

Week 7

Comments:

Use of levels -John Hopkins table lists them.

The table should be organized to present and connect the literature to the project.

jhnedp_evidence_rating_scale-1.pdf

JHNEBP EVIDENCE RATING SCALES

consensus panel (systematic review, clinical practice guidelines) Level V Opinion of individual expert based on non-research evidence. (Includes case

studies; literature review; organizational experience e.g., quality improvement and financial data; clinical expertise, or personal experience)

QQUUAALLIITTYY of the Evidence

A High

Summative reviews

Organizational well-defined methods using a rigorous approach; consistent results with sufficient sample size; use of reliable and valid measures

Expert Opinion expertise is clearly evident B Good Research reasonably consistent results, sufficient sample size, some control, with fairly definitive conclusions;

reasonably consistent recommendations based on fairly comprehensive literature review that includes some reference to scientific evidence

Summative reviews

Organizational Well-defined methods; reasonably consistent results with sufficient numbers; use of reliable and valid measures; reasonably consistent recommendations

Expert Opinion expertise appears to be credible. C Low quality

or major flaws

Research little evidence with inconsistent results, insufficient sample size, conclusions cannot be drawn Summative reviews

undefined, poorly defined, or limited search strategies; insufficient evidence with inconsistent results; conclusions cannot be drawn

Organizational Undefined, or poorly defined methods; insufficient sample size; inconsistent results; undefined, poorly defined or measures that lack adequate reliability or validity

Newhouse R, Dearholt S, Poe S, Pugh LC, White K. The Johns Hopkins Nursing Evidence-based Practice Rating Scale. 2005. Baltimore, MD,

The Johns Hopkins Hospital; Johns Hopkins University School of Nursing.

SynthesisMatrixTable1.docx

Synthesis Matrix Chart

	Source 1	Source 2	Source 3	Source 4	Source 5
APA Reference Citation
Purpose of the Study/Article
Is this a research study? If it is an experimental research design, list the independent and dependent variables. If research but not experimental design, what is the study design? If this source is not a research study, what type of literature is represented in the resource?
What level of evidence is represented in the resource?
What are the findings/recommendations in this resource that are relevant to your project?
How does this resource support your proposed DNP project?

SynthesisMatrixTable11.edited12ndassignment1.docx

Synthesis Matrix Chart

	Source 1	Source 2	Source 3	Source 4	Source 5
APA Reference Citation	Tesfa, S., Giru, B. W., Bedada, T., & Gela, D. (2021). Mental distress and associated factors among hospitalized medical-surgical adult inpatients in public hospitals, Addis Ababa, Ethiopia, 2020: Cross-sectional study. Psychology Research and Behavior Management, Volume 14, 1235–1243. https://doi.org/10.2147/prbm.s319634	Sveinsdóttir, H., Zoëga, S., Ingadóttir, B., & Blöndal, K. (2020). Symptoms of anxiety and depression in surgical patients at the hospital, 6 weeks and 6 Months post-surgery: A questionnaire study. Nursing Open, 8(1), 210–223. https://doi.org/10.1002/nop2.620	Casida, J. M., Davis, J. E., Zalewski, A., & Yang, J. J. (2018). Night‐time care routine interaction and sleep disruption in adult cardiac surgery. Journal of Clinical Nursing, 27(7–8). https://doi.org/10.1111/jocn.14262	Josephs, C. A., Shaffer, V. O., & Kucera, W. B. (2022). “Impact of mental health on general surgery patients and strategies to improve outcomes. The American SurgeonTM, 89(6), 2636–2643. https://doi.org/10.1177/00031348221109469	Bailey, E. A., “Wirtalla, C., Sharoky, C. E., & Kelz, R. R. (2018). Disparities in operative outcomes in patients with comorbid mental illness. Surgery, 163(4), 667–671. https://doi.org/10.1016/j.surg.2017.09.029
Purpose of the Study/Article	This study aims “to assess the prevalence of mental distress and identify associated factors among hospitalized medical-surgical adult inpatients in public hospitals.	The purpose of this study is to “describe the prevalence of symptoms of anxiety and depression in surgical patients at three-time points: at the hospital post-surgery, 6 weeks post-discharge, and 6 months post-discharge. The study also aims to detect situations and experiences that predict symptoms of anxiety and depression at later time points.	This study aims to explore the influence of NCRIs on night-time sleep effectiveness (NSE) and daytime sleepiness (DSS) in patients in cardiac surgery critical-care and progressive-care units.	This literature review aims to investigate how mental health disorders (MHD) impact the outcomes of general surgery patients and suggest strategies for improvement.	This study aims to evaluate the relationship between mental health comorbidities and surgical outcomes, including prolonged length of stay, in-hospital mortality, and postoperative complications, in patients undergoing common general surgery procedures.
Is this a research study? If it is an experimental research design, list the independent and dependent variables. If research but not experimental design, what is the study design? If this source is not a research study, what type of literature is represented in the resource?	This study is a research with a cross-sectional study design	This is a research study that uses a prospective, explorative two-site follow-up design.	This is a research study that uses an exploratory design	This is not a research study. It is a literature review that analyzes existing research and studies	This is a research study that uses a retrospective cohort design
What level of evidence is represented in the resource?	Lower level of evidence as it is a cross-sectional study	This resource represents moderate evidence, as it uses a prospective study design to examine symptoms of anxiety and depression in surgical patients over time.	This resource represents moderate evidence as it employs an exploratory research design to examine the impact of NCRIs on sleep-related variables.	This literature review represents high level of evidence as it synthesizes information from multiple studies.	Moderate level of evidence
What are the findings/recommendations in this resource that are relevant to your project?	The study found that the prevalence of mental distress among hospitalized medical-surgical adult inpatients in public hospitals was 53.1%. Several factors were significantly associated with mental distress, including marital status, employment status, residence, alcohol use, previous psychiatric illness, and comorbidity.	The study found that a proportion of patients presented with moderate-to-severe anxiety or depression at different time points. It identified various predictors for anxiety and depression, including not feeling rested upon awakening and higher scores on the Hospital Anxiety and Depression Scale (HADS). The findings emphasize the importance of recognizing psychological distress in surgical patients and the potential benefits of good sleep during recovery.	The study found that frequent NCRIs are common in cardiac surgery units, and further research is needed to draw definitive conclusions about their impact on sleep and daytime sleepiness in adult cardiac surgery patients. Only one of the eight NCRIs (postoperative exercises) was significantly related to sleep variables.	Mental health disorders significantly impact surgical outcomes, including increased post-surgical pain, extended hospital stays, complications, readmissions, and mortality, while decreasing wound healing and quality of care. To optimize outcomes, the review suggests integrating more effective perioperative screening tools and interventions, such as artificial intelligence-based tools, cognitive behavioral therapy, virtual reality, pharmacological approaches, and resilience training.	The study found that patients with comorbid mental health diagnoses had a higher risk of prolonged length of stay and increased odds of any complication after adjusting for confounders. The odds of death were slightly lower in the mental health diagnosis cohort. The study suggests that recognizing these disparate outcomes is the first step in understanding how to optimize care for this population.
How does this resource support your proposed DNP project?	This resource provides valuable information about the prevalence of mental distress and its associated factors in a medical-surgical inpatient setting, which is relevant to the project topic on effectively managing behavioral health/mental health illness in a medical-surgical unit.” It highlights the importance of considering these factors when developing strategies for managing mental distress in such patients.	This resource provides valuable insights into the mental health aspects of surgical patients, which is relevant to my proposed project on managing mental health in a medical surgical unit. It highlights the need for early identification and support for patients experiencing symptoms of anxiety and depression during the surgical and postoperative phases.	This research highlights the importance of managing sleep and sleep disruptions in a medical setting, which can indirectly impact the mental well-being of patients. It provides insights into the potential factors affecting the sleep quality of surgical patients, which is a component of behavioral health management in a medical surgical unit.	This resource provides crucial insights into the direct relationship between mental health and surgical outcomes, which is relevant to my project. It suggests practical strategies for addressing mental health concerns in general surgery patients, which can inform my efforts in effectively managing behavioral health/mental health illness in a medical surgical unit.	This resource provides essential insights into the impact of mental health comorbidities on surgical outcomes, emphasizing the need to consider and address mental health in general surgery. It directly supports my project's focus on managing behavioral health/mental health illness in a medical-surgical unit.” It highlights the importance of optimizing care for patients with mental health comorbidities.

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