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Psychiatric Nurse Practitioner Residents Improve Quality and Mental Health Outcomes for Veterans Through Measurement-Based Care

McGuinness, Teena M.; Richardson, Jessica W.; Nicholson, W. Chance; Carpenter, Jennifer; Cleveland, Cynthia; Rodney, Kanini Z.; Harper, Doreen C.

The Journal for Healthcare Quality (JHQ): March/April 2019 - Volume 41 - Issue 2 - p 118–124
doi: 10.1097/JHQ.0000000000000180
Original Article

Introduction: Measurement-based care (MBC) is commonly used to manage medical illness, whereas only about 20% of psychiatric care providers use MBC. One aim of the partnership between the Birmingham Veterans Affairs Medical Center (BVAMC) and the University of Alabama at Birmingham School of Nursing (UAB SON) is to provide MBC to Veterans. The goal is to describe the efficacy of MBC in the treatment of Veterans by psychiatric-mental health nurse practitioner (PMHNP) residents.

Purpose: By teaching PMHNP residents evidence-based assessment, they gain tools to shorten time to remission of depression, anxiety, and posttraumatic stress disorder.

Methods: Residents administered the Patient Stress Questionnaire (PSQ), an MBC tool that assesses depression, anxiety, trauma-related symptoms, and alcohol use, to patients of the Residency Continuity Clinic (RCC). Patient Stress Questionnaire scores from March 2016 to May 2018 were analyzed using paired t tests.

Results: Analysis revealed a downward trend in PSQ scores over time, suggesting improvement in psychiatric symptoms. Depressive and anxiety symptoms decreased significantly.

Conclusions/Implications: This quality project highlights the utility of MBC by PMHNP residents in an RCC. Measurement-based care tools can be quickly and easily administered with little impact on workflow. Use of validated screening tools can enhance care, engage patients, and improve patient outcomes.

For more information on this article, contact Teena M. McGuinness,

Supported in part by the Veterans Administration Nursing Academic Partnership between the Birmingham Veterans Affairs Medical Center and the University of Alabama at Birmingham School of Nursing. The information or content and conclusions are those of the authors and should not be construed as the official position or policy, nor should any endorsements be inferred by the Veterans Health Administration.

The authors declare no conflicts of interest.

Approval was granted at both the University of Alabama at Birmingham and the Birmingham VA Medical Center to conduct this quality improvement project.

© 2019 National Association for Healthcare Quality
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