Increasing Depression Screenings in Adults With Advanced Non-Surgical Heart Failure Using 2013 ACCF/AHA Recommendations and Healthy People 2020 Target Goals

Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Jean Dols


Steven Rodriguez


The purpose of this evidence-based practice project was to increase depression screenings in adults with non-surgical advanced heart failure using reliable and valid tools, 2013 American College of Cardiology Foundation/American Heart Association recommendations, and Healthy People 2020 Target Goals as a method to identify and facilitate appropriate mental health referral, patient education, and follow-up for depressive symptoms. Interventions took place June 5, 2017, through August 10, 2017. This intervention project involving 246 adults with advanced heart failure demonstrated that an evidence-based intervention for depression screenings increased the number of patients screened from 5% to 44%. At project completion, 65% of patients received patient education, 80% were offered a referral for further evaluation, and 81% were scheduled for follow-up. Of the 108 patients screened, 30% had positive Patient Health Questionnaire-2 screenings and 16% had scored on the Patient Health Questionnaire-9 ≥ 10. The analysis of the Patient Health Questionnaire-9 demonstrated that questions 1, 3, 4, and 6 had higher rates of occurrence in a largely Hispanic population of adults with non-surgical advanced heart failure. An analysis of the data demonstrated higher rates of depressive symptoms in patients with a New York Heart Association functional class III (51%) and class C (84%). This project also found that patients with advanced-stage heart failure and depressive symptoms were younger, had higher brain natriuretic peptide levels, and lower left ventricular ejection fractions compared with studies that include all stages of heart failure.

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