Medicine and Health Sciences Commons^™

Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor

Doctor of Nursing Practice Projects

Depression remains an increasingly prevalent and underdiagnosed disorder affecting approximately 21 million adults in the United States with only 66% seeking treatment (NIMH, 2022). Untreated depression can lead to worsening mental and physical health which negatively impacts a person’s quality of life. The implementation of routine depression screening in primary care is recommended by the US Preventive Services Task Force (USPSTF) to improve early detection leading to improved outcomes (USPSTF, 2023). Despite increased depression prevalence and USPSTF recommendation, there remained an absence of routine depression screening in a primary care practice in Midwest Illinois which led to the development of …

Implementation Of Routine Screening To Detect Early Cases Of Depression And Anxiety In Hispanic Adolescents In The Primary Care Setting, Latoya Hayward

Doctor of Nursing Practice Projects

Depression and anxiety are among the leading causes of illness and disability in adolescents and are two of the most prevalent mental health conditions in Latino youth. If left unrecognized and untreated, these conditions can lead to decreased quality of life and increased rates of suicide. Researchers recommend early mental health screening to occur in the primary care setting. Through routine screening using evidence-based screening tools (PHQ-9 and GAD-7), the primary goal of this quality improvement project was to increase early detection of depression and anxiety in primary care and initiate early treatment. Project methods included implementation of new workflow, …

Improving Depression Surveillance At The We Care Clinic, Kaitlin Springer, Emma Hanney

Doctor of Nursing Practice Projects

Depression is one of the most underdiagnosed and untreated disorders affecting more than 16 million people in the United States each year (Henry et al., 2020). Unmanaged depression can lead to emotional suffering, decreased productivity, reduced income, impaired relationships, and an increased risk for comorbidities (Sinisalchi et al., 2020). It can affect anyone, however, individuals who are non-white, female, undereducated, disabled, pregnant or postpartum, have low socioeconomic status, or lack social support are at an increased risk (United States Preventative Services Task Force, 2019). The Southern Illinois University Edwardsville We Care Clinic provides primary care to minority patient populations who …

"Program Evaluation On The Use Of The Screening, Brief Intervention And Referral To Treatment (Sbirt) Process In Primary Care Physician Offices", Lisa Sanchez-Navarro

Doctor of Nursing Practice (DNP) Manuscripts

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an early screening intervention tool for individuals with non-dependent substance use, which is employed to identify and provide care before a patient needs extensive specialized treatment. SBIRT can be used in primary care settings, to methodically screen individuals who might not seek help for a substance use issue (Centers for Medicare & Medicaid Services, [CMS], 2020). Gaps in using the SBIRT screening process were identified within the insurance organization’s PCP practices, therefore, a program evaluation was completed to: (a) determine whether Primary Care Physicians (PCPs) were using the SBIRT process, (b) …

Using A Psychopharmacology Education Program To Increase Primary Care Provider Comfort With Treating Basic Psychiatric Disorders, Latesha Reed

DNP Scholarly Projects

BACKGROUND: Almost 1 in 5 people have been diagnosed with a mental health illness but the supply of psychiatric providers does not meet patient’s needs. Multiple reasons contribute to this shortage and nurse practitioners are part of the solution. Even with nurse practitioners specializing in psychiatric mental health there is still a shortage. Primary care is where most patients first present their mental health issues.

METHODS: Literature review informed the development of the educational intervention presented to the primary care providers using a digital, asynchronous learning format. A gap analysis of organizational needs and weaknesses was used to determine the …

Creating Opportunities For Personal Empowerment: A Project Evaluation, Ann L. Cudney

Doctoral Projects

Introduction: 66% of individuals in the United States who experienced a major depressive episode in the last year saw a general practitioner or family doctor and not a psychiatrist or psychotherapist (Center for Behavioral Health Statistics and Quality, 2018). Many primary care providers treat with medication, however, a combination of medication and psychotherapy is associated with better results (Anxiety and Depression Association of America, n.d.). A Midwestern faith-based healthcare organization implemented a pilot cognitive behavioral therapy program at a family medicine residency clinic to improve mental health care.

Objectives: The purpose of this project was to evaluate if the implementation …

The Effect Of The Screening, Brief Intervention, Referral To Treatment (Sbirt) Model On Adult Depression In An Outpatient Setting, Genevieve E. Sweeney

Doctoral Projects

Depression is one of the most common chronic conditions in the world. Despite this, depression continues to be under-screened, inaccurately assessed and diagnosed, and poorly treated in outpatient settings. Many providers solely rely on clinical judgement instead of a screening tool or evidence-based toolkit when a patient presents with depression symptoms, resulting in underdiagnosis and inappropriate treatment. Utilization of resources can help a provider appropriately screen, diagnose and treat an individual with depression. Screening, Brief Intervention, Referral to Treatment (SBIRT) is an evidence-based model intended to improve these measures. Studies from the literature support the efficacy of the SBIRT model …

A Common Goal: Primary Care And Psychiatry Improve Depression Detection And Outcomes, Katherine Kilkenny

Doctor of Nursing Practice Final Manuscripts

Background: Major Depressive Disorder (MDD) affects over 15 million (6.7%) adult Americans. While one in four primary care patients suffer from depressive symptoms, MDD is accurately diagnosed as little as 25% of the time.

Purpose: Implementation of an evidence-based protocol outlining the process for screening, behavioral health referral, and the role of a collaborative care team would improve detection and treatment of adult MDD patients in the ambulatory setting.

Process: A systematic Patient Health Questionnaire (PHQ-9) based screening protocol was implemented. Every new and existing patient completed the PHQ-9 during scheduled primary care appointments. If a patient scored 15 or …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

The Effect Of Routine Adult Phq-2 Depression Screen And Scheduled Follow-Up Protocol In The Primary Care Setting, Alex F. Bikowski

Evidence-Based Practice Project Reports

Healthy People has projected depression to be the primary cause of disability by 2020; therefore routine depression screening has been prioritized as a national healthcare initiative. The purpose of this Evidence-Based Practice (EBP) project is to demonstrate that routine implementation of the 2-item Patient Health Questionnaire (PHQ-2) depression screener, along with a scheduled follow-up protocol for adults in the primary care setting, can improve current mental health practices regarding the identification of depression by clinicians. The evidence supports use of the PHQ-2 for routine adult depression screening, as long as a scheduled follow-up protocol is available for positive screens. This …

Primary Care "Catches" Up With Behavioral Health, Michael Hannes Thorarinson

Nursing Theses and Capstone Projects

The problems caused by the lack of care coordination between primary care and behavioral health are well documented. Patients with uncontrolled mental health issues along with chronic health problems cost two to three times the health care dollars to manage than patients who have the same chronic health problems but without uncontrolled mental health issues. Despite this, in rural North Carolina, the de facto level of care coordination is none. Mental health and primary care are completely separate, distinct systems that do not routinely communicate. One of the identified barriers to care coordination is the lack of reimbursement for the …

Screening For Alcohol Use/Abuse In The Primary Care Setting Using The Audit-C And Sbirt (Screening, Brief Intervention, Referral To Treatment), Whitney D. Spear

DNP Projects

PURPOSE: The purpose of this study was to examine the feasibility of alcohol screening in the primary care setting to detect alcohol abuse or misuse using the AUDIT-C standardized screening tool and SBIRT.

METHODS: This study design was a Quasi-Experimental intervention, one group post-test. Data was collected via retrospective chart review from the electronic medical records by the type of office visit; either new patient initial visit or annual well visit. The patient sample consisted of 25 participants for the study period of September 19^th through October 10^th, 2017.

RESULTS: There were 37 patients eligible to participate …