Date of Conferral

11-20-2025

Date of Award

November 2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Jill Walsh

Abstract

I developed this Doctor of Nursing Practice (DNP) project to create a clinical practice guideline (CPG) aimed at improving depression remission rates at an outpatient clinic where outcomes were below national benchmarks. National standards for managing major depressive disorder (MDD) prioritize remission as the primary treatment goal. I identified a practice gap involving inconsistent follow-up care, irregular use of PHQ-9 assessments, and non-standardized workflows. The guiding question for this project was: Will a CPG that is designed to improve depression remission rates at 12 months be approved by subject matter experts (SMEs) using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool? To address this, I conducted a systematic literature review and critically appraised evidence to develop the CPG. A panel of five SMEs evaluated the guideline using the AGREE II tool, with responses submitted anonymously. The AGREE II panel review revealed consistently strong scores across all items in the six domains, with mean values ranging from 5.80 to 6.40 based on a Likert scale from 1 (strongly disagree) to 7 (highly agree). Based on their feedback, I revised the CPG and then assessed its usability with end users, who rated it as practical and feasible. This CPG has the potential to enhance remission rates, improve consistency in terms of care delivery, and align clinical practice with national standards. Quarterly audits of PHQ-9 completion rates are recommended to monitor adherence. Ultimately, this project supports nurses and behavioral health providers in leading evidence-based mental health interventions, promoting equitable care for underserved populations, and reducing the long-term impact of untreated depression.

Download

Share

 
COinS