Date Available
5-4-2015
Year of Publication
2015
Degree Name
Doctor of Nursing Practice
Advisor
Dr. Peggy El-Mallakh
Committee Member
Dr. Jan Findlay
Co-Director of Graduate Studies
Dr. Martha Bruce
Abstract
Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This review prompted the development and implementation of a depressive disorder protocol implemented in a HH agency. The second manuscript describes the results of a process evaluation, which examined HH clinician fidelity of the protocol. Trained HH clinicians did administer the PHQ-9 according to protocol and seemed more comfortable recording higher depression scores. However, trained clinicians did not refer to a mental health nurse more frequently. Important ways in which the Doctor of Nursing Practice (DNP) prepared clinician can improve care in this area are identified. The report concludes with a policy position statement and recommendations for policy change to improve depression care for older HH patients at various stakeholder levels. Programs that integrate depression care with chronic illness management make good use of HH agency resources and can be operationally and financially feasible.
Recommended Citation
Schirmer, Sarah R., "Improving Depression Care for Older Home Health Patients" (2015). DNP Projects. 44.
https://uknowledge.uky.edu/dnp_etds/44
Included in
Clinical and Medical Social Work Commons, Clinical Psychology Commons, Community Health Commons, Counseling Psychology Commons, Family Practice Nursing Commons, Geriatric Nursing Commons, Nursing Administration Commons, Other Mental and Social Health Commons, Other Nursing Commons, Other Psychology Commons, Psychiatric and Mental Health Commons, Psychiatric and Mental Health Nursing Commons, Psychiatry Commons, Public Health and Community Nursing Commons, Social Work Commons
