Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-6-2022

Graduate Advisor

Anne Thatcher CNP, MSW, APRN, PMHNP-BC, LMSW

Committee

Anne Thatcher CNP, MSW, APRN, PMHNP-BC, LMSW

Roxanne Reid DNP, MSN-Ed., RN

Julie Brooks RN, MSN

Abstract

Problem: A burn injury affects both psychological and physical health, resulting in a greater than 50% major depressive disorder morbidity. The purpose of this quality improvement (QI) project is to evaluate the use of the Patient Health Questionnaire-9 (PHQ-9) in adult burn survivors, with an aim to increase the use of the screening tool.

Methods: A mixed-methods pre/post-survey design with an educational component was utilized to assess nurse knowledge, confidence, willingness, and barriers to completion of the PHQ-9. Aggregate data were collected to determine PHQ-9 completion rates for patients admitted to and discharged from the unit during the two months prior and two months following the educational component.

Results: A Wilcoxon signed-rank test found statistically significant differences in median nursing pre/post survey results ranging from z = .93 to z = 3.70, p < .05. Question five was the only non-statically significant result with z = 0.93, p = 0.93. PHQ-9 completion rates before the educational component were 6% on admission, compared to 40% after the education component, a 33.3% increase. Completion rates were 0% at discharge initially, compared to 13% after the education, an 86.8% increase.

Implications for Practice: This QI project accomplished the aim of increasing the use of the PHQ-9 in burn survivors and simultaneously increased the nurses’ knowledge, confidence, and willingness in completing the tool, as well as identifying barriers to completion as reported by the nurses.

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