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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Brandi Pravecek


quality improvement, depression screening, depression, PHQ-9, rural health, adults, implementation, protocol


Introduction: The United States Preventative Service Task Force (USPSTF) (2016) recommends healthcare providers screen for depression in adults and that adequate systems are in place to diagnose, treat, and provide follow-up for depressed individuals.
Methods: The current body of knowledge in regards to depression screening was reviewed. Themes such as: Rural setting, the Patient Health Questionnaire-9 item version (PHQ-9), and depression screening protocols were reviewed. The purpose of this project was to implement a depression screening protocol and provide depression education to staff in a rural healthcare organization in the Upper Midwest.
Gaps: There were a lack of studies that implemented depression screening protocols in adults in the primary care setting or that took place in the rural Upper Midwest. Other gaps in the literature were a lack of studies that focused on goal setting, outcome metrics, depression remission, algorithms for depression screening, or a standardized approach for depression management.
Recommendations for Practice: Standardizing the depression screening process and providing education focused on depression and screening may help to close the gap between primary care and mental health resources. Individuals with depression are entitled to adequate mental health interventions and more likely to be identified if screened at every encounter.

Library of Congress Subject Headings

Depression, Mental -- Diagnosis.
Medical screening.
Rural health.
Rural mental health services.



Number of Pages



South Dakota State University


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