Date of Conferral

2-12-2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Patricia Schweickert

Abstract

This project was a clinical practice guideline (CPG) focused on anxiety screening in a primary care setting using the Generalized Anxiety Disorder (GAD-7) screening tool. The practice problem addressed general anxiety disorder and the need for standardized assessments for risk, as recently been recommended by the U.S. Prevention Service Task Force (USPSTF). Anxiety disorder is common but frequently untreated, due in part to low rates of screening. Lack of an evidence-based guideline for anxiety screening may contribute to delayed diagnosis and inconsistencies. The practice-focused question was, Does the evidence support development of an evidence-based CPG for universal anxiety screening in the ambulatory care clinic that receives expert panel quality scoring via the AGREE II Instrument and receives approval for use in practice by end users? The John Hopkins evidence-based practice model was used to guide evidence appraisal and synthesis, with 21 articles initially identified and 13 high-quality studies included, primarily Level I evidence such as systemic reviews, meta-analysis, and national guidelines. Results of the three-member expert panel AGREE II review showed quality scores for all six domains ranging from 81.5% to 97.2%. The overall quality score was 6.5/7, and the CPG was accepted for use in practice by end-users by a score of 7/7. Implementation of this CPG is expected to standardize universal anxiety screening, improve early identification of anxiety symptoms, and treatments methods. For nursing practice, the guideline provides a clear, evidence-based framework that can enhance clinical decision-making and promote consistent screening for the practice.

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