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NR 505 Week 1 Area of Interest in NP
Student Name
Chamberlain University
NR-505: Advanced Research Methods: Evidence-Based Practice
Prof. Name
Date
Week 1: Area of Interest in Nurse Practitioner (NP) Practice
Selected Area of Interest
An area of significant interest in nurse practitioner (NP) practice is the mental health of patients in primary care, specifically the screening and management of depression and anxiety. Although mental health concerns are widespread, they often remain undiagnosed or untreated. According to the National Institute of Mental Health ([NIMH], 2017), over 17.3 million adults in the United States experience depression each year, representing approximately 7.1% of the adult population. Unfortunately, persistent stigma and misconceptions surrounding mental health continue to discourage individuals from seeking help or accepting screenings (Aci et al., 2018).
To address this, I propose implementing routine annual depression and anxiety screenings for all patients during their primary care visits. This approach enables nurse practitioners to proactively identify those at risk, initiate timely interventions, and improve overall treatment outcomes. Routine screening supports holistic and evidence-based care by addressing both physical and mental well-being.
Relevance and Proposed Change
Mental health issues such as depression and anxiety significantly affect patients’ quality of life, occupational functioning, and even mortality risks. Primary care settings provide an ideal environment for early screening and intervention (Geyti et al., 2018). Nurse practitioners can integrate standardized tools—such as the Patient Health Questionnaire (PHQ-9) for adults and the PHQ-A for adolescents—to ensure reliable and measurable outcomes for timely diagnosis.
The integration of evidence-based practice into primary care contributes to comprehensive treatment, reduced suicide rates, and increased patient satisfaction. Moreover, routine screening underscores the provider’s dedication to individualized and patient-centered care (Chamberlain University, 2021).
Table 1
Proposed Change: Routine Mental Health Screening in Primary Care
| Aspect | Details |
|---|---|
| Issue of Interest | Depression and anxiety in community and primary care populations |
| Target Population | Adults (18+) and adolescents (12–17 years) |
| Screening Tools | PHQ-9 (adults), PHQ-A (adolescents) |
| Frequency of Screening | At least once annually during primary care visits |
| Expected Outcomes | Earlier diagnosis, improved treatment initiation, reduced suicide rates, enhanced patient/provider satisfaction |
| Evidence Base | Supported by studies on the effectiveness of screening in primary care (Geyti et al., 2018; NIMH, 2017) |
Response 1
How Would I Implement This Intervention?
If I were to implement routine depression and anxiety screening, I would utilize validated tools such as the PHQ-9 for adults and the PHQ-A for adolescents (ages 12–17). A score of 10 or higher would be interpreted as a positive result, warranting further evaluation and discussion of treatment options.
Each patient would complete the screening annually, with results recorded for both positive and negative outcomes. Special documentation would highlight patients diagnosed for the first time, allowing for early intervention. For individuals who screen positive, follow-up care—including therapy, medication, or referrals—would be developed and initiated on the same day as the screening (Savoy, 2016).
Measuring Outcomes
To evaluate effectiveness, the following measures would be maintained:
-
Total number of screenings completed annually
-
Comparison of positive and negative screening rates
-
Identification of new diagnoses
-
Types of interventions initiated (e.g., medication, therapy, referrals)
Continuous monitoring and follow-up visits would ensure consistent assessment of patient progress and intervention effectiveness (Maurer et al., 2018).
Table 2
Implementation and Outcome Tracking
| Implementation Strategy | Outcome Measures |
|---|---|
| Annual screenings using PHQ-9 / PHQ-A | Number of screenings conducted |
| Positive score ≥10 | Percentage of patients screening positive |
| Same-day documentation and care plan | New diagnoses identified and interventions initiated |
| Follow-up plans (therapy/medications) | Patient adherence and progress documented at subsequent visits |
Response 2
Shauna,
Your insights about the importance of addressing mental health in children and adolescents are both accurate and timely. I completely agree that the emotional struggles of youth are often underestimated or overlooked. Many parents assume that children do not face serious mental health challenges, yet academic pressures, extracurricular commitments, and social expectations create immense stress for them.
According to the Centers for Disease Control and Prevention ([CDC], 2021), approximately 10.3% of children in the United States are diagnosed with depression or anxiety, and these rates are steadily increasing. Unfortunately, many children and adolescents tend to mask their emotions, making early detection difficult until symptoms become severe.
Therefore, I firmly believe that children and adolescents should undergo annual depression and anxiety screenings, even in the absence of overt symptoms. Incorporating routine mental health screenings during school physicals or primary care visits would allow early identification and timely support, ultimately preventing the worsening of mental health issues.
Thank you for sharing your valuable perspective!
References
Aci, M., Zhang, S., Chomanczuk, A. H., O’Brian, K. H., De Zitella, M. L. M., Scrifanim, P. R., Velez, L., Garay, E., Sezer, S., Little, V., Cleek, A., & McKay, M. M. (2018). Barriers and facilitators to mental health screening efforts for families in pediatric primary care. Journal of Family Social Work, 21(3), 191–199. https://doi.org/10.1080/10522158.2018.1429212
Centers for Disease Control and Prevention. (2021). Data and statistics on children’s mental health. https://www.cdc.gov/childrensmentalhealth/data.html
Chamberlain University. (2021, September 1). Week 1 lesson: Evidence-based practice [Lecture notes]. https://chamberlain.instructure.com/courses/87542/pages/week-1-research-evidence-based-practice-and-quality-improvement?module_item_id=12780895
NR 505 Week 1 Area of Interest in NP
Geyti, C., Dalsgaard, E., Sandbæk, A., Maindal, H. T., & Christensen, K. P. (2018). Initiation and cessation of mental healthcare after mental health screening in primary care: A prospective cohort study. BMC Family Practice, 19(1), 1–9. https://doi.org/10.1186/s12875-018-0864-9
Maurer, M. M., Raymond, T. J., & Davis, B. N. (2018). Depression: Screening and diagnosis. American Family Physician, 98(8), 508–515.
National Institute of Mental Health. (2017). Major depression. https://www.nimh.nih.gov/health/statistics/major-depression
Savoy, M. (2016). Screening your adult patients for depression. Family Practice Management, 23(2), 16–20.
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