Date of Conferral

8-19-2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Catherine Garner

Abstract

Co-occurring disorders (CODs) are often underdiagnosed in outpatient behavioral health settings due to fragmented care and lack of standardized, interprofessional screening. Mental health professionals lack unified screening guidelines for CODs, limiting early detection and coordinated care, especially in high-risk populations. This project aims to develop an evidence-based clinical practice guideline (CPG) to promote interprofessional consensus and improve COD screening and management. Guided by the Johns Hopkins EBP Model and the AGREE II instrument to ensure rigor. Twelve expert reviewers (5 PMHNPs, 4 LCPCs, and 3 psychiatrists) assessed a CPG developed from nine critically appraised studies sourced from EBSCO, CINAHL, and Cochrane. Analysis of the panelists’ Likert scale ratings using the AGREE II instrument revealed that the domain mean scores ranged from 5.0 to 6.1, with “rigor of development” scoring the highest (M = 6.08) and “editorial independence” scoring the lowest (M = 5.33). Stakeholders endorsed the CPG’s practicality and cultural responsiveness. The finalized CPG integrates validated tools, shared decision-making, and workflow improvements. Key recommendations include trauma-informed care training, peer support, and EHR automation. The CPG supports equitable, culturally competent care and offers a scalable model for improving COD screening in diverse outpatient settings.

Available for download on Wednesday, October 28, 2026

Included in

Nursing Commons

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