Degree Name
Nursing Practice, DNP
Publication Date
9-30-2025
First Advisor
Lisa Drake
Second Advisor
Beatrice Bailey
Abstract
Treatment-resistant depression (TRD), defined as major depressive disorder unresponsive to at least two adequate antidepressant trials, is linked to higher morbidity, diminished quality of life, and increased healthcare utilization. Spravato (intranasal esketamine), approved by the U.S. Food and Drug Administration, provides a novel mechanism of action through N-methyl-D-aspartate (NMDA) receptor modulation but requires strict safety oversight due to risks including dissociation and hypertension. This Doctor of Nursing Practice (DNP) quality improvement (QI) project evaluated whether a targeted educational intervention improved staff knowledge and confidence in Spravato safety protocols. Guided by Lewin’s Change Theory, Bandura’s Social Learning Theory, and implemented with the Plan-Do-Study-Act (PDSA) framework, the project used a quasi-experimental pre-/post-test design with eight staff members in an outpatient behavioral health clinic. The intervention included structured training with a 10-item knowledge test and a 5-point Likert confidence scale. Knowledge scores rose from a mean of 80% (SD = 13.2) to 99% (SD = 3.5), with paired t-test results confirming significance (t(7) = -3.65, p = .008). Confidence ratings also improved across all domains, clustering at the highest levels post-intervention. The knowledge test demonstrated good reliability (Cronbach’s α = .83). Limitations included the small sample size and single-site design. Findings suggest structured training improved staff preparedness, supporting safer Spravato administration. This project highlights the role of doctoral-prepared nurses in leading evidence-based interventions that advance safety and quality in outpatient behavioral health.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Barraza Guerra, Cynthia, "Quality Improvement Project Improve Staff Knowledge on Spravato for Treatment Resistant Depression" (2025). Doctor of Nursing Practice Projects. 211.
https://arch.astate.edu/dnp-projects/211
