Date of Doctor of Nursing Practice Project Completion
Summer 8-1-2026
Faculty Advisor
Karla Abela
Abstract
PURPOSE This quality improvement project aimed to improve depression identification by screening 80% of eligible adults admitted to two heart failure intensive care units (ICU) using the Patient Health Questionnaire-9 (PHQ-9).
RESULTS Screening compliance increased from 42.1% to 85% by Week 13, exceeding the project goal. Of 101 patients screened, 16.8% screened positive for depression. Workflow changes, leadership support, and peer engagement improved compliance, though psychiatric referrals remained inconsistent.
BACKGROUND Depression is common among critically ill patients but is frequently underrecognized because ICU care primarily focuses on physiologic stabilization. Existing admission screening was limited to suicide risk assessment, delaying identification of depressive symptoms and appropriate mental health referral.
IMPLICATIONS Routine PHQ-9 screening improved depression identification and was successfully integrated into ICU nursing practice. Inconsistent psychiatric consultation highlighted the need for a standardized referral process. Continued education, leadership support, and ongoing audit and feedback are essential for sustainability. Future quality improvement should expand screening to other critical care settings.
METHODOLOGY The Institute for Healthcare Improvement Model for Improvement and Plan-Do-Study-Act cycles guided implementation. The PHQ-9 was incorporated into ICU nursing workflow. Staff education, workflow changes, leadership support, visual reminders, and peer support were introduced across successive cycles. Outcomes were evaluated through electronic health record audits, descriptive statistics, and run chart analysis.
Keywords
depression, intensive care unit, PDSA, PHQ-9, quality improvement
Keywords
depression, intensive care unit, PDSA, PHQ-9, quality improvement
Recommended Citation
Jenny C. Manoly BSN, RN, "Implementation of PHQ-9 to Improve Depression Identification in ICU" (2026). Doctor of Nursing Practice Final Project Abstract. 212.
https://digitalcommons.library.tmc.edu/dnp_abstract/212