Date of Conferral

9-28-2026

Date of Award

9-28-2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Robert Anders

Abstract

This staff education doctoral project addressed a documented gap in nursing competency, confidence, and documentation related to medication adherence counseling for adults with schizophrenia on an inpatient psychiatric unit. Nonadherence to antipsychotic medication affects an estimated 40% to 60% of adults with schizophrenia and contributes to relapse and avoidable rehospitalization. The practice-focused question was: In a psychiatric care facility, how does a competency-based staff education program on medication adherence strategies for schizophrenia affect nursing staff knowledge, confidence, and competency, as measured by pre- and post-education assessments? The intervention was developed using the analyze, design, develop, implement, and evaluate (ADDIE) model and delivered to 32 registered nurses and psychiatric staff over 12 weeks, with evidence-based appraisals using the Johns Hopkins evidence-based practice model. Mean staff knowledge scores rose from 62% to 89%, high confidence in adherence counseling rose from 42% to 89%, and 94% of staff demonstrated proficiency on direct-observation checklists. An Appraisal of Guidelines for Research and Evaluation II (AGREE II) expert panel recommended the accompanying clinical practice guideline for adoption. This project advances social justice by strengthening psychiatric nursing capacity to deliver culturally responsive, dignity-centered care to a population that experiences documented racial and ethnic treatment disparities. Limitations include a single-site design, a 12-week evaluation window, the absence of a control group, and the IRB-approved scope restriction to staff outcomes, which means no claims can be made about patient adherence or clinical outcomes.

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