Document Type
DNP Project
Department
School of Nursing
Date of Degree
Spring 2025
Degree
Doctor of Nursing Practice (DNP)
Primary Advisor
Cara Padovano, DNP, APRN
Keywords
Generalized Anxiety Disorder-7; Mental Health Screening Tools; Outpatient Clinics
Abstract
Background: Generalized Anxiety Disorder- 7 (GAD-7) screening tool as emerged as a valuable instrument for identifying GAD symptoms quickly and effectively in clinical settings. However, the successful integration of the GAD-7 tool into routine practice required adequate staff education and training. Staff members played a pivotal role in administering the GAD-7 tool, interpreting results, and facilitating appropriate interventions for patients identified with GAD symptoms. Brighterlife Healthcare had been underutilizing the GAD-7 screening tool in clinical practice. Therefore, understanding the importance of staff education on GAD-7 utilization and its implications for patient care outcomes was essential for optimizing mental health care delivery within healthcare settings, including outpatient psychiatric clinics. This project aimed to assess the impact of staff education on GAD-7 utilization and its effectiveness in improving the identification and management of GAD symptoms among patients in an outpatient psychiatric clinic setting.
Objectives: The purpose of this Quality Improvement (QI) project was to: 1) improve staff and provider knowledge about the GAD-7 tool, 2) increase the frequency of GAD-7 use in clinical practice, and 3) determine if the integration of the GAD-7 screening tool led to a higher rate of anxiety diagnoses. Specific outcomes measured included staff knowledge, tool utilization frequency, and the rate of anxiety diagnoses before and after implementation.
Methods: This quality improvement project involved staff education and training on the GAD-7 screening tool at Brighter Life Healthcare. The project targeted four participants: two psychiatric-mental health nurse practitioners (PMHNPs), one nurse, and one office assistant. Staff completed a pre- and post-training survey to assess their knowledge and confidence in using the tool. The GAD-7 was incorporated into patient check-in procedures for individuals without prior anxiety diagnoses. Chart reviews were conducted pre- and post-implementation to measure the frequency of GAD-7 utilization and changes in anxiety diagnoses. Data was analyzed using Excel to track utilization rates and diagnosis outcomes.
Results: Staff knowledge significantly improved after the training, with participants reporting increased confidence in administering and interpreting the GAD-7. Pre-implementation, the GAD7 was underutilized, with only 38% of eligible patients receiving the screening. By week five, screening rates increased to 80-91%. Additionally, of the 49 patients who completed the GAD-7, 31 scored 15 or higher, indicating severe anxiety symptoms. 24 of these patients were diagnosed with generalized anxiety disorder (GAD), representing 77% of those flagged for further assessment, demonstrating the tool's effectiveness in identifying patients needing intervention.
Conclusions: The systematic implementation of the GAD-7 screening tool resulted in improved staff knowledge, increased tool utilization, and a higher rate of anxiety disorder diagnoses. The project highlights the value of structured training and the integration of evidence-based screening tools in clinical practice. Recommendations include continued staff education, sustained use of the GAD-7, and periodic evaluations to maintain high screening rates.
Copyright Notice
©2025 Naina Shahi-Virk. All rights reserved.
Recommended Citation
Shahi-Virk, N. (2025). The Implementation of the Generalized Anxiety Disorder-7 (GAD-7) in an Outpatient Mental Health Clinic. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/173
Open Access
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