Date of Award

4-2020

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Dr. Della Hughes-Carter, DNP, RN, BC-GNP

Second Advisor

Dr. Joy Washburn, EdD, RN, WHNP-BC

Third Advisor

Sarah Faubert, LLMSW

Abstract

Depression is one of the most common chronic conditions in the world. Despite this, depression continues to be under-screened, inaccurately assessed and diagnosed, and poorly treated in outpatient settings. Many providers solely rely on clinical judgement instead of a screening tool or evidence-based toolkit when a patient presents with depression symptoms, resulting in underdiagnosis and inappropriate treatment. Utilization of resources can help a provider appropriately screen, diagnose and treat an individual with depression. Screening, Brief Intervention, Referral to Treatment (SBIRT) is an evidence-based model intended to improve these measures. Studies from the literature support the efficacy of the SBIRT model in depression treatment. This project focused on implementing the SBIRT model within two satellite primary care clinics. The purpose was to improve outcomes of patients with depression. During the 3-month implementation period, 10 patients had initial visits where the SBIRT model was utilized and 7 patients returned for follow-up visits. Results showed the average PHQ-9 scores decreased from 14.06 to 8.59 (p-value = 0.001, 95% CI [3.426, 7.512]), 7 referrals to counseling were made, 4 antidepressants were prescribed, and increased medication titration occurred for 5 patients. These results suggest that utilization of the SBIRT model improved adult depression in the outpatient setting.

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