Date of Conferral

11-25-2025

Date of Award

November 2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Camilla Jaekel

Abstract

I conducted this Doctor of Nursing Practice (DNP) project to address medication nonadherence among adults with severe mental illness (SMI) in a psychiatric care setting by developing an evidence-based clinical practice guideline (CPG) for nurse-led interventions. The identified practice gap was the absence of a standardized, evidence-informed framework to guide nurses in enhancing pharmacotherapy adherence, which is a critical issue linked to relapse, rehospitalization, and diminished quality of life in this population. This project was guided by the following practice question: Will an evidence-based guideline on nurse-led interventions to improve medication adherence in patients with SMI be approved by a panel of experts using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool? A rigorous literature review of 20 peer-reviewed articles from PubMed, CINAHL, and Cochrane informed the guideline’s development. I appraised these sources using the Johns Hopkins Individual Evidence Summary and Synthesis & Recommendations tools, ensuring methodological rigor. The guideline’s quality was evaluated by a panel of three psychiatric mental health content experts using the AGREE II instrument. The CPG achieved a mean domain score of 81.9% across the six domains, with individual domain scores ranging from 44.4% to 100%. Notably, five out of six domains surpassed the 70% benchmark, underscoring the guideline’s strong quality and applicability. Implications for nursing practice include equipping nurses with structured, evidence-based tools to address adherence barriers and support recovery. Broader impacts may include reduced psychiatric relapses, improved treatment continuity, and enhanced quality of life for individuals with SMI across inpatient and community settings.

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