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UAB Staff Education on Depression Screening Using PHQ 9 in An Out

View attached explanation and answer. Let me know if you have any questions.Staff Education on Depression Screening Using PHQ-9 in An Out-Patient Mental HealthClinic1Staff Education on Depression Screening Using PHQ-9 in An Out-Patient Mental healthClinicRita DexterSouth CollegeIn partial fulfillment of the requirements for theDoctor of Nursing PracticeDNP Project Chairperson:(Your advisor)DNP Project Members:(Committee members: faculty; preceptor)Date of Submission:(Write out the month in words; day & year in numbers)Staff Education on Depression Screening Using PHQ-9 in Mental Health Clinic2Staff Education on Depression Screening Using PHQ-9 in An Out-Patient Mental healthClinicIntroductionAccording to IsHak et al. (2017), depression has been ranked as one of the emergingmental health issues in US. Even though most people seek treatment for this disease, theinadequate recognition from clinicians compromises the process of diagnosis (O Connor et al.,2016). The clinical standards or rather guidelines recommend application of standardized typesof depression screening tool. As such, it has to been an essential requirement in evaluatingdepressive episode in psychiatry and other healthcare centers (IsHak et al., 2017). The PatientHealth Questionnaire 9, abbreviated as PHQ-9, is such a screening tool and typicallyrecommended to be used in the outpatient care setting (IsHak et al., 2017). The broad focus ofthe problem for this project is Maryland, Prince Georges County. The project s aim is to increasethe overall screening of depression among patients at the hospital-based outpatient clinic.O Connor et al. (2016) reveals that the implementation of PHQ-9 will heighten the rate ofscreening from 0% to approximately 80%. To successfully complete this particular project,hospital therapists will have to be educated about national recommendations and guidelinespertaining to PHQ-9 screening. The consistent use of this tool will facilitate the identification,diagnosis, and treatment of depression (IsHak et al., 2017). It is also speculated that the tool willimprove client outcomes dramatically.BackgroundAccording to O Connor et al. (2016), the prevalence of depression in US is approximately7%. However, an accurate diagnosis of depression requires the medics to identify the presence ofat least 5 attributable signs and symptoms for a period of two weeks (Truschel, 2020). TheStaff Education on Depression Screening Using PHQ-9 in Mental Health Clinic3project will be grounded on the fact that that about 35.4% of the people diagnosed withdepression receive what can be described as minimally inadequate medication management(IsHak et al., 2017). As such, it is a result of inappropriate or rather unreliable depressionscreening to assess treatment efficacy. The project s primary consumers will be the clients in theoutpatient care setting. The rationale for conducting the project is to help identify the people atthe highest risk of depression in the quest to improve treatment and diagnosis. The project willbe accomplished in a hospital-based setting for outpatients since such will provide the bestplatform for mass screening.Significance of the Practice ProblemThe Joint Commission requires healthcare organizations to use a standardized and evidencebased screening tool. The patients screening must be completed prior to booking an appointmentwith the medics (The Joint Commission, 2016). One of such tools is PHQ-9. The tool has as wellbeen recommended by the United States Department of Veterans Affairs to be used as thequantitative measure of the severity of symptoms during treatment (Beard et al., 2016). It hasbeen widely recommended because of its validity and reliability for screening depression,especially in adults (Beard et al., 2016). The tool has majorly been used in the psychiatry setting(Annue et al., 2012). At these centers, it is especially advocated to use a cutoff score no less thanthirteen due to its specificity and sensitivity. Therefore, within psychiatry, it helps in identifyingthe severity of the depressive episode of a given population. The target population for the projectwill be adults in the hospital-based outpatient care setting. The one possible way in whichscreening of depression using PHQ-9 save money is through the enhanced accuracy andefficiency in screening (Beard et al., 2016). Clinicians will therefore accomplish the diagnosisand treatment procedures using minimal resources and time. The current statistics show that outStaff Education on Depression Screening Using PHQ-9 in Mental Health Clinic4of 1.8 million patients discharged from Medicaid program, about 2% committed suicide after theinpatient psychiatric stay. However, these figures can be addressed with the adoption of PHQ-9screening. If care organizations do not embrace this tool, the rate of suicide cases resulting fromdepression will hit the United States population at an alarming rate (Beard et al., 2016). Giventhat depression is associated with decreased level of productivity, adopting the use of PHQ-9 toolremains to be the ultimate and lasting solution.Using a quantitative technique to measure the severity of symptoms in a patient with depressionis instrumental in making sure the clients get the support they need. There are instances where apatient has committed suicide even after getting medical help. The PHQ 9 is instrumental indetermining the severity of depression in a patient (IsHak et al., 2017). The PHQ 9 scale rangesfrom 0-27, and it has nine questions that a medical professional uses to determine the type oftreatment that a patient is going to get. The depression ranges from mild to severe depression. Ifa patient has a score of 10 and above, they are considered to have depression. However, when apatient has a score of above 20, they are considered to have severe depression (Truschel, 2020).The significance of the study is that a medical professional will have more information that willbe critical in helping the patient. There is a high chance of getting the correct treatment ifmedical personnel are aware of the depression that is bothering a patient. The medicalprofessions are therefore urged to use the tool before treating their patients. It is important tohave a standardized and evidence-based approach when dealing with a person with depression.The American Association for nurses has developed the PHQ9 tool to ensure that the medicalprofessions can take care of patients with depression scientifically. The questions that are askedby the medical profession play a key role in determining the kind of care that will be given to apatient (IsHak et al., 2017). O Connor et al., 2016). Although other tools are available in theStaff Education on Depression Screening Using PHQ-9 in Mental Health Clinic5medical field, the PHQ is used by a majority of the medical professions because it is effectiveand accurate.Purpose of the Project, Scope, and Leadership QuestionProject PurposeThe purpose of this nursing project is grounded on the implementation of the PHQ-9depression screening tool as a component of the clinic s assessment process to increase the rateof depression screening from 0% to 80% and at the same time improving the identification ofdepression. The project s goal is to heighten depression screening of clients at the hospital-basedoutpatient care setting. The project will improve the overall wellness as well as manage the careof patients struggling with depression. The screening will aid in capturing the early diagnosis ofdepression, early treatment, follow-up care, and prevention of complications attributed todepression. I will be in the position to achieve this milestone through staff education in the questto increase provider usage of the screening tool. I will also strive to improve the provider sunderstanding of the guidelines for administering the PHQ-9 depression-screening too. Staffeducation will help providers understand the importance of early detection of depression in orderto identify the most appropriate treatment and follow-up care. Overall, the project will helpidentify depression at the early stages and provide the most appropriate care.Project ObjectivesBased on the identified problem the following project objectives were developed; To improve the screening for depression by means of implementing the PHQ-9 depressionscreening tool during the initial assessment and follow-up visits.Staff Education on Depression Screening Using PHQ-9 in Mental Health Clinic 6To carry out staff training on national designated recommendations and guidelines regardingthe use of the PHQ-9 as well as the criteria for documentation and reporting depression. To evaluate and assess the weekly administration rate of the PHQ-9 by every clinic sclinician and provider with documentation of client s scores in an Excel spreadsheet To ensure accurate documentation of the patient s score so as to assess the completion rateof the PHQ-9. To design or develop a Health Stream PowerPoint online presentation for the clinic s healthprovider education on the importance of using the PHQ-9.Scope of the ProjectThe system-level of application to the practice of this project is the Meso system. Thesystem details the examination of a particular group, organization, studies, communities, orspecific components of society (WHO, 2018). For this case, the system will aid in analyzing thesignificance of PHQ-9 in screening depression, especially in an outpatient clinic. The projectaligns with the system-level application because it undergoes five essential stages, namelytraditional society, preconditions, take-off, drive to maturity, and the stage of high massapplication. The clinic staff are educated on applying the PHQ-9 screening system to ensure theyare well-versed with its components to ensure successful implementation (Rancans et al., 2018).Also, ensuring the project undergoes the system level stages means that it will be evaluated atevery phase to determine its effectiveness in addressing depression screening issues.Leadership QuestionStaff Education on Depression Screening Using PHQ-9 in Mental Health Clinic7Can the implementation of a screening strategy enhance awareness of depression,encourage the use of PHQ-9 tools, and heighten the administration of PHQ-9 for depressionscreening in an outpatient care setting?Upon completing the project, the leader will be able to sustain the outcomes by ensuringreporting and documentation of PHQ-9 scores by the clinic s staff is made a routine practice.Still, leaders should be at the forefront of advocating for the quick incorporation of these scoresinto the client assessment as well as daily therapy notes (Williams et al., 2017). The currentpatient s depressive symptoms should only be assessed with PHQ-9 (Mu oz-Navarro et al.,2017). The clinic leader should emphasize the 100% completion rate when using the PHQ-9assessment tool.Conceptual and Theoretical ModelThe project will make use of the Plan-Do-Study-Act cycle abbreviated as (PDSA). As such, it isessentially an approach (scientific) employed in action-oriented learning (Coury et., 2017). Thecycle is stenography for assessing a change through, evaluating, and responding to what islearned. Still, it best provides response regarding what does and does not work. The PDSA ismainly recognized as an iterative four-stage cycle typically used in enhancing a change (Coury etal., 2017). Following its usefulness, it has been employed in a broad range of organizations andindustries. The theoretical model aligns with the project in that it will enhance the provision ofsafe and advanced care. Basically, quality improvement approaches depend on evidence-basedand innovative practices to ensure efficient disease prevention (Hall, 2017). The project ssystematic review shows that the core tenets of PDSA may lead to positive impacts on learningas well as quality improvement. Also, with the aid of PDSA, it is possible to utilize theStaff Education on Depression Screening Using PHQ-9 in Mental Health Clinic8leadership capabilities to create a protocol to enhance the care quality for clients struggling withdepression.PICOT QuestionA PICOT can be defined in clinical term as a question that is efficient, searchable andprovides important as well as relevant information. Formulation of a PICOT questions requiresthat one understands the five important elements that are critical in addressing clinical problems.In other words, the mnemonic word PICOT was derived from important elements in questionsused in clinical research (Duquesne University School of Nursing, 2020). The study is related tothe use of PHQ-9 screening tool for screening of depression in an outpatient mental clinicTo achieve the aim of this project, the question posted here was formulated: For adultpatients eighteen years and older of age, in an outpatient mental health clinic (P), how can earlydetection using the PHQ-9 screening tool (I) compared with existing tools (C) facilitate earlydiagnosis and treatment of depression (O) over a period of two weeks (T)?The elements include the subject of the research, who is the patient, the appropriateintervention, a comparison for the study, the expected outcome as well as the time frame. A casescenario forms the first part of the PICOT progress after which the question formulated is used ineliciting an answer (Duquesne University School of Nursing, 2020). In this study, the PICOTstrategy of addressing clinical problems is used by following a specific procedure. The procedureincludes identification of the Population of interest, identification of the Issue or Intervention ofinterests as well as the Comparison of intervention. The last two components of the PICOT processinclude the expected Outcome and the Time needed for the complete implementation.There are generally 9

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