Date of Conferral
11-18-2025
Date of Award
November 2025
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Corinne Romano
Abstract
Missed appointments remain a serious problem in mental health outpatient clinics. They break the flow of treatment, waste staff time, and worsen outcomes for patients. In this setting, the practice problem is the lack of an evidence-based system for reminding patients about their visits. This doctor of nursing practice (DNP) project focused on developing and evaluating a clinical practice guideline (CPG) for automated text message (SMS) appointment reminders. The guiding question asked: Can a CPG using SMS reminders help reduce missed appointments in a mental health outpatient setting? A thorough review of CINAHL and PubMed found strong support for this approach, including 11 systematic reviews, 19 randomized controlled trials, 31 quasi-experimental or observational studies, and 22 background reports. Together, these studies confirm that SMS reminders improve attendance rates. The CPG was reviewed by an expert panel using the AGREE II tool. The panel rated the guideline highly for clarity, scope, and rigor based on a Likert scale from 1 (strongly disagree) to 7 (highly agree). The AGREE II results show that most items scored between 5 and 7, indicating generally strong consistency and quality across all evaluated areas, with several items reaching the highest average score of 7. For nursing practice, this project highlights the value of evidence-based tools that support continuity of care. In addition, this initiative supports positive social change by reducing health disparities, improving access for under-served groups, and promoting equity in mental health care.
Recommended Citation
Avoseh, James, "The Lived Experiences of Imposter Syndrome Among Women of Color Professors in Higher Education" (2025). Walden Dissertations and Doctoral Studies. 19122.
https://scholarworks.waldenu.edu/dissertations/19122
