Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Dr. Laura Kuensting


Dr. Carla Beckerle

Dr. Gordon Robinson


Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 visits were reviewed. The PMHNP was more likely to care for younger patients while the MD cared for more older patients (pp = .031). The MD was more likely to care for Caucasian patients; whereas, the PHMNPs cared for a more diverse racial or ethnic population (p p< .001). The rate of emergency department (ED) visits and hospitalizations between providers was essentially the same (p=0.40) and (p=0.31) respectively.

Implications: No determination could be made in the key outcome measures of ED visits or hospitalizations between the PMHNPs and MD due to lack of documentation in the record. However, 450 more patients per month were treated for mental healthcare needs when PMHNPs were utilized.