Date of Conferral
11-24-2025
Date of Award
November 2025
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Catherine Garner
Abstract
This Doctor of Nursing Practice (DNP) project focused on developing and evaluating an evidence-based clinical practice guideline (CPG) for the psychopharmacologic management of serious mental illness (SMI) in a state correctional health system. The project explored a critical practice gap: the unavailability of standardized, evidence-based prescribing and monitoring protocols for incarcerated individuals diagnosed with schizophrenia, major depressive disorder with psychotic features, or bipolar disorder. The evidence-based project was structured around the central question: “Will an interprofessional team achieve consensus on updating the clinical practice guideline for psychopharmacologic management of serious mental illness in state prisons, thereby improving consistency and quality of care?” The evidence-based project was supported by the Johns Hopkins Evidence-Based Practice (JHEBP) model for translating evidence into practice. A RAND modified Delphi process enhanced expert consensus, and the AGREE II instrument was used to appraise guideline quality across six domains. An interprofessional expert panel – consisting of a psychiatrist, a psychiatric nurse practitioner, a pharmacist, a mental health director, and a correctional nursing supervisor- conducted an independent review of the CPG. Mean AGREE II scores ranged from 5.9 to 6.9 (on a 7-point Likert scale), exhibiting high quality across domains of clarity, rigor, and applicability. Additionally, qualitative feedback obtained corroborated the guideline’s importance, practicality, and alignment with organizational standards. End-user reviews from correctional nurses and administrative leaders further confirmed the feasibility and utility of its clinical incorporation. Implementation of the CPG is intended to enhance prescribing consistency, interprofessional collaboration, and medication safety, while minimizing crises and behavioral incidents in correctional facilities. The limitations of this project included a small expert sample, project confinement to a single state system, and institutional barriers such as bureaucratic delays inherent in correctional settings. Despite these constraints, the evidence-based project showed that developing evidence-based guidelines is both attainable and substantive in complex healthcare systems. This DNP project contributes to the advancement of correctional psychiatry, nursing leadership, and evidence-based mental health reform, buttressing equitable access to quality care for incarcerated populations and conforming with national behavioral health standards.
Recommended Citation
Neuvieme, Clarel, "Psychopharmacologic Management of Serious Mental Illness in State Prisons" (2025). Walden Dissertations and Doctoral Studies. 18760.
https://scholarworks.waldenu.edu/dissertations/18760
