Date Available
4-24-2025
Year of Publication
2025
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
College
Nursing
Department/School/Program
Nursing
Faculty
Dr. Leslie Scott
Committee Member
Dr. Jessica Rice
Faculty
Dr. Julie Marfell
Abstract
Background: Suicide is the 2nd leading cause of death in adolescents across the United States (US). Primary care providers (PCPs) are often the first people an adolescent sees for depression or suicide symptoms; however, evidence shows PCPs may not be comprehensively screening for suicide in the primary care setting by using the Patient Health Questionnaire (PHQ) alone. Screening tool usage for depression and suicide among PCPs is currently at rates as low as 26% due to lack of knowledge and insufficient resources. Evidence-based education on American Academy of Pediatrics (AAP) recommendations can improve PCPs’ knowledge, skills, and attitudes when assessing for depression and suicide in primary care. Comprehensive screening for suicide and depression, as well as providing up-to-date mental health resources, can fill the gap of those adolescents being under-screened for suicide risk with depression screening alone.
Purpose: The purpose of this study was to increase referrals to the newly implemented 3-digit suicide hotline, and improve the knowledge, skills, and attitudes of APRNs across the state of Kentucky towards screening children for depression and suicide in primary care.
Methods: A quasi-experimental one group pretest-posttest design with an educational intervention was used. The educational module and surveys were sent via email to the Kentucky Association of Nurse Practitioners and Nurse Midwives (KANPNM) listserv. The educational intervention was a 42-minute Prezi presentation with a recorded voiceover that focused on current evidence-based suicide screening recommendations that align with the AAP. This included the Ask Suicide Screening Questions (ASQ), the ASQ plus PHQ, the ASQ toolkit, clinical pathway, suicide resources, and information on the newest crisis lifeline, 988. Pre- and post-Qualtrics surveys were used to assess provider knowledge, skills, and attitudes when screening for suicide in primary care. Survey results were analyzed using IBM SPSS and descriptive statistics/frequencies. Results: A total of six providers participated in the study. Six providers participated pre-intervention and one provider post-intervention. The study noted a slight improvement in the knowledge, skills, and attitudes of APRNs across the state of Kentucky when screening children for depression and suicide in primary care, and an increase in referrals to the 3-digit suicide hotline.
Discussion: Understanding current screening and referral practices for children during this national mental health crisis is crucial to identify more children with a suicide risk and reduce suicide rates. The impact of an educational module for providers with updated screening tools, recommendations, and resources provided by the AAP can be beneficial to provider knowledge and skills when screening for suicide. Future studies should focus on larger sample sizes and various specialties nationwide to determine if an educational module significantly identifies more children with a suicide risk.
Recommended Citation
Higginbotham, Brooklyn D., "Evaluating Knowledge, Skills, Attitudes, and Suicide Hotline Referrals in APRNs Screening Children for Depression and Suicide in Primary Care" (2025). DNP Projects. 485.
https://uknowledge.uky.edu/dnp_etds/485
