Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Dr. Heather Chappell

Second Advisor

Dr. Luanne Shaw

Academic Year



Background: Individuals prescribed Second-Generation Antipsychotics (SGAs) face an increased risk of developing metabolic syndrome (MetS), characterized by a higher prevalence of metabolic abnormalities such as diabetes, dyslipidemia, hypertension, and obesity. This heightened susceptibility significantly raises the chances of developing cardiovascular disease and type 2 diabetes (Abdulhaq et al., 2021; Chen & Nasrallah, 2019).

Objectives: This quality improvement project aims to address the management of MetS in patients with severe psychiatric disorders prescribed SGAs. Applying the theory of planned behavior (TPB) framework, this project seeks to gain insights into the determinants shaping clinician behavior and provide a comprehensive understanding of the reasons behind adherence or non-adherence to MetS management guidelines.

Methods: The intervention includes developing and evaluating an educational toolkit to enhance the knowledge, confidence, and skills of clinic staff in providing care for this patient population. Educational meetings were held, standardized screening protocols were established, and a workflow for ordering referrals to primary care physicians was implemented.

The plan-do-study-act (PDSA) cycle was used for the quality improvement tool.

Findings: The project findings indicate that the standardized screening protocol effectively identifies individuals at risk for metabolic syndrome and promotes appropriate referrals.

The implementation of the educational toolkit and screening protocol significantly support providers' confidence in screening metabolic health in patients, as evidenced by a statistically significant increase in overall M-BACK scores from pre implementation to post implementation (score = 8.69, p = .013, d = .38, N=44 ). However, there are opportunities for improvement, specifically regarding completion rates for specific risk factors and timely access to lab results.

Included in

Nursing Commons