Degree Name
Nursing Practice, DNP
Publication Date
4-27-2026
First Advisor
Sandy King
Second Advisor
Alisha McAfee
Abstract
Depression is a prevalent and debilitating mental health condition that remains significantly underdiagnosed in primary care, despite national recommendations for universal adult screening. At the project site, less than 40% of adults completing annual wellness visits had documented depression screening. The purpose of this quality improvement project was to evaluate whether integrating the evidence-based Patient Health Questionnaire (PHQ)-2 and PHQ-9 into the electronic health record (EHR) would improve completion of depression screening, documentation, and referrals to treatment. The project was guided by Rogers' Diffusion of Innovations Theory and the Plan-Do-Study-Act (PDSA) framework. A quantitative pre–post intervention design linked with the PDSA framework was adopted over a six-week implementation period in an outpatient primary care clinic. Nurses and medical assistants were educated on depression screening and used EHR-integrated PHQ-2/9 tools during adult wellness visits to screen for depression. Project outcomes were evaluated through retrospective chart reviews and analyzed using descriptive statistics and chi-square tests. Results demonstrated statistically significant improvements across all outcome measures, with screening rates increasing from 30.0% pre-intervention to 89.7% post-intervention, missed documentation reduced from 77.1% to 10.3%, and referrals to treatment increasing from 4.4% to 17.3% (all p < .001). The findings supported that integrating PHQ-2/9 depression screening tools into EHR was effective in enhancing routine practice involving depression screening within the project site. The project will contribute to nursing practice by supporting preventive mental healthcare through early identification, documentation, and improved referrals to treatment in primary care settings.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Denchukwu, Nina, "Quality Improvement Project: Integrating Depression Screening into Adult Wellness Visits in a Primary Care Clinic" (2026). Doctor of Nursing Practice Projects. 338.
https://arch.astate.edu/dnp-projects/338
