Degree Name
Nursing Practice, DNP
Publication Date
4-28-2025
First Advisor
Mary Newkirk
Second Advisor
Diane Hare
Abstract
Chronic mental health conditions such as anxiety, depression, and post-traumatic stress disorder (PTSD) are frequently treated by nurse practitioners (NPs) in outpatient private practices. Despite the evidence supporting Cognitive Behavioral Therapy (CBT) as a first-line intervention, its utilization remains limited in NP settings, often due to lack of training and confidence. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate whether a structured train-the-trainer program could improve NP confidence in applying CBT in practice. Guided by the Iowa Model and Kotter’s 8-Step Change Model, this quality improvement project utilized a quasi-experimental, pre-post survey design to assess changes in NP confidence. A total of nine NPs participated in a 12-week CBT training and mentorship program. Confidence was measured using a validated survey administered before and after the intervention. Results showed a statistically significant increase in NP confidence scores (p = 0.00026) following the intervention. These findings support the project's PICOT question: In NP private practice (P), does the implementation of a train-the-trainer CBT program (I), compared to standard pharmacologic treatment alone (C), impact NP confidence in applying CBT (O) before and after the program (T)? This project demonstrates that the train-the-trainer model can effectively increase provider confidence, enabling broader integration of CBT into NP-led mental health care. The findings highlight the potential to shift practice patterns toward more holistic, evidence-based treatment and reduce overreliance on medication, ultimately enhancing the quality of patient care in outpatient settings.
Rights Management
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Waters, Chioma, "Quality Improvement Project Enhancing Patient Care in Nurse Practitioner Private Practices: A Train-The-Trainer Approach to Implementing Evidence-Based Chronic Mental Disease Management Interventions" (2025). Doctor of Nursing Practice Projects. 205.
https://arch.astate.edu/dnp-projects/205
