Title

Quality Improvement on Depression Protocols in the Military Training Environment

Date of Degree

12-2018

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Danielle Gunter

Advisor

Eugene Garcia

Abstract

Background: Active Duty military members are highly susceptible to depression and suicide due to separation from family during training and deployments, exposure to traumatic experiences in combat, and loss of friends during combat.

Purpose and Objectives: Depression and suicide remain a high priority among military personnel. This process improvement project aimed to improve the rate of depression screening and improve the assessment, treatment, and management of soldiers with depression in a primary care setting to prevent disease progression while waiting to be seen by a behavior health specialist.

Interventions: During the 6-week time frame, all active duty military and reservists seen in a primary care clinic were screened for depression using the Patient Health Questionnaire-2 (PHQ2). All positive PHQ2 screenings moved on to the more in depth Patient Health Questionnaire-9 to measure depression symptoms and severity. Based on symptom severity, initiated treatment plans included education, material resources, psychotherapy, pharmacotherapy, safety contracts and Behavioral Health referral.

Evaluation plans: Patient screening forms were gathered weekly to assess for 100% screening and 100% treatment initiation of all positive depression screenings. After the 6-week time period, a review of data was performed to assess adherence and sustainability.

Implications for practice: Diagnosis of depression before symptoms progress minimizes patient complications, morbidity and most importantly minimizes mortality. Utilizing the patient centered care model, patients and healthcare personnel can work together to provide the best treatment to improve the health of the service member while temporarily assigned away from their primary care providers at their home base.

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