Date of Conferral

2017

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Linda Matheson

Abstract

People living with HIV/AIDS (PLWHA) are 4 times more likely to have a diagnosis of depression than persons without HIV. The specific problem at a rural clinic in a southern region of the United States, was a lack of continuity in the Patient Health Questionnaire 9 (PHQ-9) screening procedures that made sure that PLWHA were screened, identified, and referred. Early identification and treatment can help patients cope with barriers that affect health outcomes. The purpose and goal of this project was to develop and implement an evidence-based depression screening protocol to improve clinical staff practices and adherence to the PHQ-9 guidelines thereby increasing the number of PLWHA who were diagnosed and treated for depression. The Iowa model of evidenced-based practice served as a guide for this project. An interdisciplinary team was assembled to develop protocols and staff training. This project compared clinic staff knowledge on depression through pre and posttests. Upon completion of staff training, the pretest had a M = 78.33 and SD = 11.146 and the posttest a M = 99.17 and a SD = 2.887. Results of a paired t test confirmed a statistically significant increase in knowledge with p < .000. Over a 4-week period, depression screenings at the study site went from 10% to 100%. Data showed that positive social change was realized when PLWHA began to get depression treatment because of proper screening, early interventions, and depression management. Although the project is designed for the PLWHA in the rural clinic, other primary care providers may find that an evidenced-based practice protocol can be useful to improve PHQ-9 depression-screening practices for patients in other clinical areas.

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