Date of Conferral
8-11-2026
Date of Award
August 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Susan Huehn
Abstract
Perimenopause is a common but frequently underrecognized stage of reproductive aging that can significantly affect women's physical, psychological, cognitive, and sexual well-being. In primary care, inconsistent provider education and the absence of standardized screening and assessment processes often contribute to delayed recognition and fragmented management. The purpose of this Doctor of Nursing Practice quality improvement project was to develop, implement, and evaluate an evidence-based clinical practice guideline to improve the identification and initial management of perimenopause in a primary care setting. Guided by the Johns Hopkins Evidence-Based Practice Model, the project involved synthesizing and critically appraising the literature to develop a clinical practice guideline that included a standardized screening tool, assessment algorithm, documentation guidance, provider education resources, referral pathways, and outcome evaluation measures. A five-member expert panel with expertise in advanced practice nursing, primary care, and women's health evaluated the guideline using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Reviewer feedback was incorporated before implementation. Following implementation, identification of patients with perimenopausal symptoms improved from approximately 30% to 70%. Provider confidence increased, documentation became more consistent, and standardized screening was successfully integrated into routine clinical workflow. Stakeholders reported that the guideline was feasible, clinically relevant, and easily incorporated into existing practice. Although implementation was limited to a single primary care site, the findings demonstrate that a standardized clinical practice guideline can improve recognition and initial management of perimenopause and support more consistent evidence-based care. This project highlights the role of the Doctor of Nursing Practice–prepared nurse in translating evidence into sustainable practice change and contributes to improved women's health, health equity, and patient-centered care. Keywords: perimenopause, menopause, primary care, clinical practice guideline, evidence-based practice, quality improvement, women's health, AGREE II, Johns Hopkins Evidence-Based Practice Model, screening
Recommended Citation
Banire, Yewande, "Improving Identification and Initial Management of Perimenopause in Primary Care" (2026). Walden Dissertations and Doctoral Studies. 20640.
https://scholarworks.waldenu.edu/dissertations/20640
