Date of Conferral

2-17-2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Gross

Abstract

This Doctor of Nursing Practice (DNP) project involved the development of a clinical practice guideline (CPG) for implementing structured telepsychiatry follow-up visits to reduce relapse rates and emergency department (ED) use among adults with bipolar disorder. The project addressed the growing need for accessible, evidence-based psychiatric follow-up care, particularly for patients facing barriers to consistent in-person visits. The practice-focused question guiding this project was: In adults with bipolar disorder, how do structured telepsychiatry follow-up visits, compared with in-person visits, affect relapse rates and Ed utilization? A systematic review and critical appraisal of current evidence were conducted using the Johns Hopkins Nursing evidence-based practice model and the AGREE II tool. The analytical strategy included synthesis of evidence from nine peer-reviewed studies. Findings indicated that structured telepsychiatry interventions provided outcomes comparable to in-person care in managing bipolar disorder while also improving access, continuity, and patient satisfaction. The CPG recommends implementing biweekly or monthly telepsychiatry sessions post-stabilization, using validated tools (e.g., Patient Health Questionnaire-9 [PHQ-9] and Mood Disorder Questionnaire [MDQ]) to monitor symptoms, and integrating family education into telehealth visits. Adoption of this guideline is expected to improve continuity of care, enhance early relapse detection, and reduce unnecessary ED visits and cost. The project promotes positive social change by expanding fair access to psychiatric care for underserved populations and strengthening nursing leadership in evidence-based psychiatric treatment delivery.

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