Date of Conferral

10-21-2026

Date of Award

October 2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Catherine Garner

Abstract

This quality improvement project evaluated a standardized adult attention-deficit/hyperactivity disorder (ADHD) assessment and management protocol in a private outpatient psychiatric practice. Four psychiatric nurse practitioners conducted evaluations independently, resulting in variable screening, documentation, and stimulant safety review. A baseline review of 40 charts showed documented screening with the Adult ADHD Self-Report Scale version 1.1 (ASRS-v1.1) in 32.5% of charts, complete criteria from the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) in 45.0%, substance-use screening in 27.5%, and cardiovascular screening in 35.0%. The practice-focused question addressed whether a standardized protocol would improve diagnostic documentation and safe prescribing adherence. Evidence was gathered from quality standards, national guidance, and clinical and validation literature. The intervention included a six-step protocol, provider education, and ongoing feedback. Descriptive statistics were used for analysis. A postimplementation audit of 40 charts showed ASRS-v1.1 use at 87.5%, DSM-5 documentation at 90.0%, substance-use screening at 82.5%, and cardiovascular screening at 85.0%; every measure exceeded the 80% benchmark. Limitations included a small single-site sample, a short implementation period, single-reviewer audits, and no control group. Sustained electronic health record integration, periodic chart audits, new-provider orientation, and annual evidence review were recommended. Standardizing minimum assessment and safety requirements can strengthen nursing practice, promote positive social change, and support consistent, equitable care.

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