Date of Award

Spring 5-2-2025

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Kathleen Clark DNP, RN, PHN, CFCS

Second Advisor

Amy Nelso PhD, RN

Abstract

This Doctor of Nursing Practice (DNP) quality improvement project aimed to address gaps in the continuum of care for adolescents experiencing depression symptoms at a school-based health clinic (SBHC) within an alternative learning community school (ALCS) in southeast Minnesota. Adolescent depression rates are on the rise and are only exacerbated by systemic barriers and social determinants of health, requiring improved mental health care access. Guided by Madeleine Leininger’s Culture Care Theory, the project focused on improving follow-up care for students with elevated depression scores on the Patient Health Questionnaire-9 (PHQ-9-M). A tracking system was developed, and the SBHC nurse contacted students with PHQ-9-M scores of nine or above to ensure follow-up. Over two academic years (2022–2024), the project saw significant improvements in follow-up rates and reductions in depression scores. In the first year, only 14% of students had a follow-up plan, while in the second year, this increased to 49%. Furthermore, 94% of students who were followed-up with in year one demonstrated reduced PHQ-9-M scores, with 72% showing similar improvement in year two. The project aligns with the American Association of Colleges of Nursing (AACN) Essentials, specifically related to person-centered care, quality and safety, and interprofessional partnerships, demonstrating the importance of follow-up care. Recommendations include leveraging the electronic medical record for automated follow-up reminders and expanding mental health outreach.

Identifier

SC 11.DNP.2025.Nigon.L.

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