Abstract

Introduction. Depression diagnoses in the United States continue to rise within the primary care setting. At a free primary care clinic in the Southeastern United States, the PHQ-9 screening tool was being used to screen patients for depression, but providers were not regularly addressing positive screenings. Aims. This quality improvement project aimed to evaluate health care staffs' awareness, attitudes and confidence towards depression screening and management and implement best practices in primary care identification and follow up for depression.

Methods. Health care staff at a primary care clinic responded to Revised Depression Attitudes Questionnaire (RDAQ) pre-and post-surveys to measure their awareness, attitudes, and confidence regarding depression. In addition, data were collected on Patient Health Questionnaire-9screenings, depression diagnosis and treatment plans to measure depression screening and follow-up. Data was evaluated in four-week cycles according to Plan-Do-Study-Act model.

Results. Participant surveys indicated optimism toward depression screening and management but a lacked confidence in their clinical management of depression. After implementation, PHQ-9 screening remained steady across the three PDSA cycles with 83%, 75%, and 89% of primary care patients being screened. Both a depression diagnosis and treatment plan were documented for 60% (cycle 1), 28.5% (cycle 2), and 31% (cycle 3) of PHQ-9s with scores five or greater. Eight patients had both a baseline and follow-up PHQ-9 score with six of their scores improving by at least one point.

Conclusions. Implementation of an evidence-based depression screening and management protocol in the primary care setting can support clinical care and follow-up.

Description

Advisor Details: Lindsay Wolf, DNP, APRN, CPNP-PC, CNE, CLC - Graduate Director for DNP Program, Keigwin School of Nursing; Dorcas Kunkel, DNP, RN, CNE, PHNA, CPHIMS - DNP Secondary Reader; Leigh Hart, PhD, APRN-BC - Associate Dean, Keigwin School of Nursing

Ashley Gagne

Author Details

Ashley Gagne, DNP, ARNP-C - Graduate Student DNP Program, Keigwin School of Nursing; Lx

Sigma Membership

Theta Tau

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Depression, Adults, Adult Depression, Primary Care, Primary Care, Free Clinic

Advisors

Wolf, Lindsay||Kunkel, Dorcas||Hart, Leigh||de Tantillo, Lila

Advisor

Lindsay Wolf

Second Advisor

Dorcas Kunkel

Third Advisor

Leigh Hart

Fourth Advisor

Lila de Tantillo

Degree

DNP

Degree Grantor

Jacksonville University

Degree Year

2021

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Faculty Approved: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2021-06-07

Full Text of Presentation

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