Defense Date

7-17-2025

Graduation Date

Summer 8-1-2025

Submission Type

Dissertation/Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Doctor of Nursing Practice (DNP) Program

School

School of Nursing

Faculty Mentor

Frank Kosnosky

Keywords

anxiety, depression, mental health disorders, health risk behaviors, substance use, drug use, electronic screening, outpatient, primary care office, college health

Abstract

Establishing a standardized electronic screening process for mental health disorders and health risk behaviors is crucial for early identification and intervention before poor outcomes occur. This quality improvement project addresses a gap in care relating to screening practices in a college health services office which primarily relied on a provider-based interview screening processes in students reporting for care. Pre-implementation data showed providers most often screened for Major Depressive Disorder (MDD), alcohol use, and drug use, with inconsistent screening for Generalized Anxiety Disorder (GAD) or tobacco/vaping use. Follow-up screening form administration was also inconsistent, only given 3.3% of the time for a positive provider screening result.

Based on the Plan-Do-Study-Act (PDSA) Framework for Quality Improvement, a standardized electronic screening process with a step-wise approach was implemented to better identify the needs of the students. The new screening process was sent to any student making an appointment for a physical over a two-month period; there were 132 participants total. Screening instruments included the Patient Health Questionnaire (PHQ) Tool, General Anxiety Disorder (GAD) Tool, and Tobacco, Alcohol, Prescription medication, and other Substance use Tool (TAPS), which automatically generated further questions for positive screenings. Post-implementation quantitative and qualitative data showed support in the importance of adopting a standardized electronic screening process to bridge this gap in care. Findings highlighted that the new process lead to improved identification of mental health disorders and health risk behaviors among students, and it was more efficient to use in the college health office setting.

Language

English

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