Degree Name
Nursing Practice, DNP
Publication Date
6-24-2026
First Advisor
Lisa Drake
Second Advisor
Alisha McAfee
Abstract
Medication nonadherence affects 50% to 70% of individuals with serious mental illness. This contributes to symptom relapses, hospitalization, poor treatment outcomes, and higher healthcare costs. The purpose of this quality improvement project was to evaluate the impact of a competency-based Medication Adherence Rating Scale (MARS) training program on provider confidence and standardized adherence screening in a psychiatric clinic, to improve confidence and increase use of a standardized assessment. Guided by Bandura's Self-Efficacy Theory and Lewin's Change Management Model and implemented using the Plan-Do-Study-Act framework, the project used a quantitative quasi-experimental pre-post design with eight psychiatric mental health nurse practitioners. Data collection included a demographic questionnaire, the Grundy Provider Confidence Scale, de-identified electronic health record documentation of MARS utilization, and a post-training satisfaction survey. Provider confidence increased significantly from pre-intervention (Mdn = 5.0, IQR = 5.0–6.0) to post-intervention (Mdn = 25.0, IQR = 24.3–25.0), z = -2.59, p = .01. The MARS was documented in 2,639 of 2,870 eligible encounters, a 92.0% utilization rate, and all eight providers responded favorably to the training. The main limitation was the small convenience sample from a single practice. This project demonstrated that competency-based education and standardized adherence screening meaningfully improved provider confidence and strengthened evidence-based psychiatric practice. By embedding the MARS into routine care, the findings advance knowledge and lay a foundation for sustained improvement in medication-adherence management and patient outcomes.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Cheek, Tamara, "Quality Improvement Project Improving Provider Confidence for Medication Adherence Screening Through Use of the Medication Adherence Rating Scale (MARS)" (2026). Doctor of Nursing Practice Projects. 355.
https://arch.astate.edu/dnp-projects/355
