Date of Conferral
11-7-2025
Date of Award
November 2025
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Jill Walsh
Abstract
Background: Treatment-resistant depression (TRD) presents a significant clinical and administrative challenge, delaying access to evidence-based therapies such as intranasal esketamine (Spravato). Inconsistent documentation and lack of standardized clinical pathways contribute to insurance authorization delays, exacerbating health inequities and care fragmentation. Purpose: This DNP project aimed to develop and implement a standardized Treatment History Checklist and Clinical Practice Guideline to streamline documentation, support timely insurance authorization, and promote equitable access to Spravato therapy for patients with TRD. Methods: Using a systems change framework, the project employed gap analysis, stakeholder engagement, and iterative validation to design tools aligned with payer requirements and clinical best practices. Results: AGREE II evaluation tool was utilized by an expert panel to ensure that the checklists would improve documentation completeness, reduce authorization turnaround times, and increased provider confidence in navigating complex insurance processes. Conclusion: Standardized documentation and guideline-driven care checklists can reduce administrative barriers, enhance clinical efficiency, and advance health equity in psychiatric treatment access. This project offers a scalable model for nurse-led innovation in Spravato treatment centers.
Recommended Citation
Scott, Margaret Mae, "Development and Implementation of a Treatment History and Authorization Checklist to Improve Access to Spravato Therapy for Treatment-Resistant Depression" (2025). Walden Dissertations and Doctoral Studies. 18654.
https://scholarworks.waldenu.edu/dissertations/18654
