Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2023


Doctor of Nursing Practice (DNP)

Primary Advisor

Dr. Cara Padovano; Dr. Flavia Kostov; Sunny Grestky


Depression Screening; Hematology; Oncology; Outpatient Clinic


Background: Oncology patients have multiple factors that can lead to depression, such as treatments, end-of-life decisions, stressors from home, pain, financial responsibilities, and transportation needs. If depression goes unaddressed, it can diminish the quality of life in oncology patients.

Objectives: (1) The purpose of this evidence-based practice (EBP) project is to improve Hematology/ Oncology (HEM/ONC) patient quality, with improved screening (PHQ-9 screening tool) and identification as well as referral for adult patients (18 and older). (2) Assess the knowledge, perception of depression, and confidence level of utilizing the PHQ-9 screening tool in the hem/onc outpatient clinic staff. (3) To increase staff and provider knowledge, perception of depression, and confidence level of depression within outpatient clinics such as Peninsula Cancer Institute and Infusion Center (PCI)

Methods: Implementing EBP to improve utilizing the depression screening instrument PHQ-9 in the hem/onc outpatient population to identify patients with depression. A multi-staff assessment with a pre-and post-study design was implemented for this project, which will help to identify and measure the knowledge, attitude, perception, and confidence in depression screening.

Results: The intervention group had 724 patients screened, 184 tested positive (25.41%), and 149 were treated (20.58%). The control group had 850 participants, 0 screened with PHQ-9, 0 positive test, and 0 treatments for depression. Overall, post-testing scores from the Wilcoxon signed rank test showed improvement from pre/post-survey testing.

Conclusion: This project shows overall positive results with the need for increased depression screening within the hem/onc setting, as well-made changes in the prevailing attitude, perception, and awareness of the need for depression screening with staff. With positive outcomes, it is essential to this patient population that this EBP be the permanent workflow. Collaboration in the organization should be a priority for sustainability and policy change, and all patients should be screened with PHQ-9 screening tools.

Open Access


Included in

Nursing Commons



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