Date of Conferral

5-14-2025

Date of Award

May 2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Sue Bell

Abstract

Depression affects more than 21 million U.S. adults annually and is a leading cause of disability worldwide. Unidentified and untreated depression is associated with poor patient outcomes including chronic disease, disease exacerbation, increased healthcare utilization, decreased quality of life, and suicide. The aim of this staff education project was to increase the use of the Patient Health Questionnaire-9 (PHQ-9) for depression screening in a primary care clinic. The clinical practice problem identified was the underutilization of a standardized depression screening tool, leading to missed or delayed depression diagnoses. The project addressed the question of whether education of the health care professionals in a primary care clinic setting would improve adherence to national depression screening guidelines and increase staff knowledge in scoring and applying the PHQ-9 tool to determine treatment or referral. The evaluation of the project included a pretest–posttest design to measure the knowledge outcomes of the 11 participants. Staff knowledge of the screening purpose increased from 65% to 92%, of the national administration guidelines from 58% to 89%, of scoring and interpretation from 60% to 94%, and of correct follow-up actions from 55% to 91%. A retrospective postimplementation chart review showed an increase from screening new patients only to screening all patients during every visit. The project has implications for advancing nursing practice by promoting routine depression screening to address a known health disparity, unidentified mental health issues among primary care practice patients. Social change was promoted by standardizing primary health care delivery to detect depression and provide early treatment and referrals for improved holistic patient care and better outcomes.

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