Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2023


Doctor of Nursing Practice (DNP)

Primary Advisor

Dr. Mercedes Echevarria


Major Depressive Disorder, Mood disorder, Depression, depression screening, treatment, referral, behavioral health, depression remission, primary care, nursing education, relapse prevention, collaborative care


Background: Depression is one of the most common and treatable mental health conditions. Untreated depression causes emotional suffering, reduced productivity, lost wages, increased comorbidity risks, and increased healthcare costs.

Purpose: The purpose of this project was to implement Collaborative Care Interventions (CCI) to achieve the Uniform Data System (UDS) Measure of Depression Remission.

Aims: The AIMS of this project were: (a) Increases the percentage of nursing staff compliance and completion of the educational training; (b) increases nursing staff knowledge of recognition of depression signs and symptoms, early identification of depression, and administration to all adult patients; (c) Increase the percentage of PHQ screening tools utilization by nursing staff for all adult patients for the outcome to identify depression; (d) Increase the percentage of initiation of the treatment plan and referrals to mental health to provide treatment care plans for all adult patients; (e) Increase the percentage of clinic staff compliance with documentation of the follow-up process to assess outcomes from treatment for all adult patients and; (f) Increase the percentage of providers’ compliance with providing relapse prevention education to all adult patients.

Methods: This Quality Improvement project used a descriptive, pre-post same-participant design. Interventions included collecting and analyzing pre-intervention and post-intervention data, mandatory educational training for all nursing staff, and implementing Collaborative Care Interventions.

Results: 125 charts were reviewed. An increase in initiating the treatment plan post-intervention (Pre: 100 %, N=6, post: 100%, N=11) was found but not in post-intervention referrals (pre: 100%, N=4, post: 75%, N=3). Documentation of the follow-up process increased (pre: 66.7%, N=2, post 100%, N=11). Relapse prevention education was observed (27.3%, N=8). All nurses completed the training (100%, N=3), and survey mean scores increased (pre: x̅=87%, post x̅=100%). Chi-square analyses were conducted to determine the differences in screening for depression pre-and post-intervention. no significant difference in use of PHQ-2 post-intervention (X2 = 1.541, df =1, p=0.215). Statistical significance difference in post-intervention use of PHQ-9 screening tool (X2 = 10.516, df=1, P=0.001).

Conclusions: Increase in post-intervention screening and initiation of treatment plans suggest that promoting recognition, screening for depression, and providing appropriate treatment plans may assist with depression remission.

Open Access


Included in

Nursing Commons



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