Date of Conferral

1-28-2026

Date of Award

January 2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Cara Krulewitch

Abstract

Medication non-adherence affects 49% of psychiatric patients and contributes to poor outcomes and increased hospitalizations. At the project site, 40% of patients demonstrated suboptimal adherence and 12 medication-related incidents occurred. Nursing staff lacked specialized training in motivational interviewing and comprehensive adherence assessment. This project developed and implemented an evidence-based educational program to enhance nursing competencies in psychiatric medication adherence counseling. Seven nursing staff members (5 registered nurses, 2 licensed practical nurses) participated in a 90-minute session incorporating the four-domain assessment framework, motivational interviewing techniques, and psychoeducational strategies. The ADDIE framework guided program development with interactive discussions, case-based learning, and role-play activities. Participants completed 20-item knowledge tests, 15-item confidence scales, and 15-item competency assessments pre and post-intervention. Knowledge scores increased from 59% to 94% with a cohort average of 59.3% proportional gain. Confidence ratings improved from 2.8 to 4.2 out of 5.0, representing a 50% increase. Competency ratings increased from 2.5 to 4.0 out of 5.0, representing a 60% increase. Wilcoxon signed-rank test results confirmed statistical significance (W = 0, p < .05). All participants rated the program excellent and intended to change practice behaviors. The intervention enhanced nursing competencies in psychiatric medication adherence support. Recommendations include ongoing training, standardized protocols in the electronic health record, and program expansion to other facilities.

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