Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Dianne Slager

Second Advisor

Darleen Hoffert

Third Advisor

Jamie Lamers


Depression is a leading cause of disability in adults and is a major contributor to burden of disease (World Health Organization [WHO], 2018). The United States Preventative Services Task Force (USPSTF) provides evidence-based recommendations to promote disease prevention. Among these, is the recommendation that all adults, regardless of risk factors, should be screened for depression in the primary care setting with adequate systems in place to allow for appropriate diagnosis and management (USPSTF, 2016). The purpose of this Doctor of Nursing Practice (DNP) student project was to develop and implement an evidence-based protocol in the primary care setting with aims to improve the recognition and treatment of depression. The project’s objectives included increasing the frequency of depression screening at annual wellness visits, utilizing the Patient Health Questionnaire-2 (PHQ-2) or Patient Health Questionnaire-9 (PHQ-9) screening tool for continued monitoring of depressive symptoms, and improving depression management. This student-led quality improvement project was based upon evidence-based interventions. Implementation of the protocol in an urban primary care clinic resulted in a significant improvement in rates of use of the PHQ tools, supported consistent accurate documentation of depression management plans, and significantly improved accurate billing for the service provided.

Additional Files

C. Fowler Powerpoint.pdf (5142 kB)