Leading Evidence-Based Practice Change
Depression is a serious and debilitating mental health disorder that affects millions globally and is one of the leading causes of disability. The grant proposal aims to address the practice problem of depression-related suicide by implementing a practice change project based on evidence-based practices. The long-term goal of this project is to reduce the incidence of depression-related suicide and enhance patient outcomes concerning depression and suicide risk within our healthcare organization.
The proposed practice change project aligns with our healthcare organization’s mission to improve our patients’ and communities’ health and well-being, and this grant proposal provides a detailed plan for achieving these objectives. This grant proposal will address the specific aim, background, translational model, project setting, intervention and approaches, data collection instruments, outcome, protection of participants and funding.
Specific Aims
This project aims to improve the rates of screening for depression, which prompt timely interventions that could improve suicide rates by implementing PHQ-9 (patient health questionnaire-9) and Columbia-suicide severity rating scale (C-SSRS) screening tools (Wasserman et al., 2020). By doing so, this project hopes to increase access to proper care and support for patients experiencing depression or suicidal ideation. Ultimately, this practice change project is intended to improve the quality of patient care, leading to better health outcomes and overall patient well-being.
Background and Significance
The grant proposal aims to obtain funding to support the implementation of PHQ-9 (Patient Health Questionnaire-9) and Columbia-suicide severity rating scale (C-SSRS) screening tools to reduce the incidence of depression-related suicide and enhance patient outcomes. Depression-related suicide is a significant health practice problem that needs to be addressed, with an estimate of over 700,000 suicide deaths annually.
According to World Health Organization (2021), the incidence of depression-related suicide has been increasing in recent years. It is the fourth leading cause of death among individuals between 15 and 29. Depression is also a significant cause of disability, affecting the ability of individuals to function in their daily lives. Depression-related suicide is a multifaceted problem requiring a comprehensive approach to address it effectively. Therefore, this grant proposal aims to implement evidence-based practices to reduce the incidence of depression-related suicide and improve patient outcomes in our healthcare organization.
According to Greenberg et al. (2021), there was a 12.9% increase in US adults with major depressive disorder (MDD) between 2010 and 2018, from 15.5 million to 17.5 million. In addition, the proportion of adults aged 18-34 with MDD increased from 34.6% to 47.5% during this period, with an incremental economic burden of MDD in adults increasing by 37.9%, from $US236.6 billion to $326.2 billion. Therefore, addressing this problem is essential to reduce the economic and mortality ramifications of depression-related suicide.
Implementing evidence-based practices is crucial in reducing the incidence of depression-related suicide. Evidence-based practices such as depression screening, suicide risk assessment, and evidence-based interventions have been shown to improve patient outcomes concerning depression and suicide risk (Mann et al., 2021). These evidence-based interventions can lead to improved patient outcomes through early identification of patients at risk, developing of appropriate treatment plans, and using effective interventions based on research.
The stakeholders for this practice change project include healthcare providers, patients, families, and the community. Healthcare providers will benefit from this practice change project by receiving training on evidence-based practices for depression screening, suicide risk assessment, and interventions. This training will improve their ability to identify patients at risk of depression-related suicide and provide appropriate care and support. Patients and their families will benefit from this project by receiving improved quality of care, leading to better health outcomes and overall patient well-being. The community will benefit from this project by reducing the incidence of depression-related suicide and the economic and mortality ramifications of this problem.
` The grant funding will implement PHQ-9 (patient health questionnaire-9) and Columbia-suicide severity rating scale (C-SSRS) screening tools to reduce the incidence of depression-related suicide and enhance patient outcomes in our healthcare setting. The specific solution to address the problem of depression-related suicide includes training healthcare providers on evidence-based practices, implementing a depression screening tool, and developing a suicide risk assessment tool.
he grant funding will also provide evidence-based interventions, such as psychotherapy and medication management, to patients at risk of depression-related suicide. The project will also include ongoing monitoring and evaluation of the program’s effectiveness, including patient outcomes and healthcare provider adherence to evidence-based practices.
Translational Science Model
The appropriate translational science model to guide this implementation project is the RE-AIM framework. This model allows for evaluating the project’s success across five dimensions. Firstly, Reach assesses the extent to which the intervention reaches the target population, ensuring that screening tools are widely accessible and effectively identifying individuals at risk (Titler, 2022).
Secondly, Effectiveness measures the impact of the intervention on reducing depression-related suicide by monitoring changes in patient outcomes over time.
Thirdly, Adoption focuses on the degree to which healthcare providers and the organization embrace and integrate the screening tools into routine practice. Fourthly, Implementation evaluates the tools’ fidelity and consistency, ensuring proper administration and follow-up procedures are in place. Finally, Maintenance assesses the sustainability of the intervention by monitoring long-term adherence to screening practices and associated outcomes.
Setting
This grant proposal aims to address the practice problem of depression-related suicide in a long-term psychiatric and mental health care facility by implementing evidence-based practices to improve depression screening, suicide risk assessment, and evidence-based interventions. The specific population served by the organization includes individuals of all ages who may be at risk of depression-related suicide, focusing on those between 15-35 years of age who are at higher risk, regardless of their ethnic, racial, and cultural diversity within the community.
Interventions and Approach
A systematic review and meta-analysis by Miller et al. (2021) emphasized the effectiveness of standardized depression screening tools, such as the Kessler psychological distress scale (K6+) and PHQ-9, in identifying individuals at risk of depression-related suicide. The study underscored the importance of early detection and intervention in reducing suicide rates. This suggests that implementing these screening tools in primary healthcare settings can be crucial in identifying individuals who may require immediate support.
Furthermore, Saini et al. (2020) conducted a randomized controlled trial highlighting educational programs’ significance for healthcare professionals, specifically nurses, in suicide prevention. The study demonstrated that these programs can enhance healthcare professionals’ knowledge and attitudes toward suicide, empowering them to identify and manage at-risk individuals.
Additionally, Mann et al. (2021) found that evidence-based interventions, such as psychotherapy and pharmacotherapy, have a substantial impact on reducing the incidence of depression-related suicide and improving overall patient well-being. Healthcare systems can effectively address depression-related suicide, enhance public health, and improve the overall well-being of individuals suffering from depression by adopting these interventions and approaches.
Data Collection Instruments
A team of healthcare professionals, including nurses, will collect the data. The team will be responsible for administering the Kessler psychological distress scale (K6+), patient health questionnaire (PHQ-9), and the Columbia suicide severity rating scale (C-SSRS) to patients identified as at risk of depression-related suicide. The data collected will include demographic information, screening results, patient outcomes, and the incidence of depression-related suicide.
The reliability and validity of the surveys and questionnaires will be ensured by employing established and validated instruments such as the PHQ-9 and the C-SSRS, which have been extensively tested and shown to be reliable and valid for assessing depression and suicide risk.
Data Collection Methods
Data collection will occur within the healthcare facility where the intervention is implemented. The project team of healthcare professionals, such as nurses, psychologists, and psychiatrists, will collect data. They will administer the Kessler psychological distress scale (K6+), patient health questionnaire (PHQ-9), and the Columbia suicide severity rating scale (C-SSRS) to patients identified as at risk of depression-related suicide.
These measurements will be taken at specific intervals, such as during initial patient screenings, follow-up assessments, and periodic monitoring throughout the project’s duration. Nurses’ adherence to evidence-based practices will be assessed through ongoing observation, chart audits, and staff surveys. The data collection process will be consistent, coordinated, and closely monitored to ensure accurate and comprehensive data for evaluating the effectiveness of the interventions and making informed decisions for continuous improvement.
Outcomes (Evaluation Plan)
The primary outcome of evidence-based interventions is to decrease the occurrence of suicide related to depression by identifying individuals who are at risk through standardized screening tools. The program will be monitored and evaluated to assess the proposed evidence-based intervention’s effectiveness in addressing depression-related suicide. The project team will gather data on the frequency of depression-related suicide within the healthcare organization before and after implementing the evidence-based practices. This will allow for a comparison that will help determine the intervention’s effectiveness in reducing such incidents.
Protection of Participants
Potential risks to the participants in this change project include psychological distress and emotional discomfort that may arise during the screening process and discussions about depression and suicide. Participants at risk of depression-related suicide may experience heightened vulnerability and require additional support and resources.
Furthermore, there is a potential risk of breach of confidentiality if sensitive patient information is not adequately protected. To ensure the protection of participants, ethical considerations will be addressed to safeguard participant information. Informed consent will be obtained from participants, clearly explaining the project’s purpose, procedures, potential risks, and benefits (Bhandari, 2021). Healthcare professionals involved in data collection and interventions will be appropriately trained and supported to handle sensitive issues and provide the necessary support to participants.
Funding
The data collection tools for the grant proposal will consider several options, including electronic health records (EHR) for standardized data collection and storage, online surveys for gathering information from patients and healthcare providers, mobile applications for real-time self-reporting and support, data analytics tools for analysis and visualization, and validated clinical assessment tools for reliable data collection such as PHQ-9 (Patient Health Questionnaire-9) and Columbia-Suicide Severity Rating Scale (C-SSRS).
Some funds will be allocated for the development and customization of a depression screening tool and a suicide risk assessment tool tailored to the healthcare organization’s specific requirements. These expenses will cover software development, licensing fees, and customization of existing tools, as customized tools have been proven to enhance accuracy and reduce depression-related suicide rates (O’Rourke et al., 2022).
Additionally, the data collection process will involve hiring data analysts, acquiring data collection tools, and implementing evaluation surveys to assess the program’s effectiveness, patient outcomes, and healthcare provider adherence to evidence-based practices.
Expenses will also be needed to cover the training of healthcare providers on evidence-based practices for depression screening and suicide risk assessment. The funding will be needed to organize training sessions, hire trainers or consultants, develop educational materials, and conduct follow-up assessments to ensure healthcare providers have acquired the necessary skills and knowledge (Richard et al., 2023).
Investing in training will improve the quality of patient care, leading to better health outcomes. Additionally, funding will be needed for community outreach activities to raise awareness about depression-related suicide and the availability of support services (Castillo et al., 2019). These efforts include organizing educational events, producing informational materials, or collaborating with community organizations. Securing funding for these purposes is crucial for successfully implementing the change project.
References
Bhandari, P. (2021, October 18). A guide to ethical considerations in research. Scribbr. https://www.scribbr.com/methodology/research-ethics/
Castillo, E. G., Ijadi-Maghsoodi, R., Shadravan, S., Moore, E., Mensah, M. O., Docherty, M., Aguilera Nunez, M. G., Barcelo, N., Goldsmith, N., Halpin, L. E., Morton, I., Mango, J., Montero, A. E., Rahmanian Koushkaki, S., Bromley, E., Chung, B., Jones, F., Gabrielian, S., Gelberg, L., & Greenberg, J. M. (2019). Community interventions to promote mental health and social equity. Current Psychiatry Reports, 21(5), 1–14. https://doi.org/10.1007/s11920-019-1017-0
Greenberg, P. E., Fournier, A.-A., Sisitsky, T., Simes, M., Berman, R., Koenigsberg, S. H., & Kessler, R. C. (2021). The economic burden of adults with major depressive disorder in the United States (2010 and 2018). PharmacoEconomics, 39(6). https://doi.org/10.1007/s40273-021-01019-4
Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving suicide prevention through evidence-based strategies: A systematic review. American Journal of Psychiatry, 178(7). https://doi.org/10.1176/appi.ajp.2020.20060864
Miller, P., Newby, D., Walkom, E., Schneider, J., Li, S. C., & Evans, T.-J. (2021). The performance and accuracy of depression screening tools capable of self-administration in primary care: A systematic review and meta-analysis. The European Journal of Psychiatry, 35(1), 1–18. https://doi.org/10.1016/j.ejpsy.2020.10.002
O’Rourke, M. C., Jamil, R. T., & Waqar Siddiqui. (2022, June 30). Suicide screening and prevention. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK531453/
Richard, O., Fabrice Jollant, Billon, G., Attoe, C., Vodovar, D., & Piot, M.-A. (2023). Simulation training in suicide risk assessment and intervention: A systematic review and meta-analysis. Medical Education Online, 28(1). https://doi.org/10.1080/10872981.2023.2199469
Saini, V., Gehlawat, P., & Gupta, T. (2020). Evaluation of knowledge and competency among nurses after a brief suicide prevention educational program: A pilot study. Journal of Family Medicine & Primary Care, 9(12), 6018–6022. https://doi.org/10.4103/jfmpc.jfmpc_984_20
Titler, M. G. (2022, February 14). Translation research in practice: An introduction | OJIN: The online journal of issues in nursing. Ojin.nursingworld.org. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No2-May-2018/Translational-Research-in-Practice.html#Table2
Wasserman, D., Iosue, M., Wuestefeld, A., & Carli, V. (2020). Adaptation of evidence‐based suicide prevention strategies during and after the COVID‐19 pandemic. World Psychiatry, 19(3), 294–306. https://doi.org/10.1002/wps.20801
WHO. (2021, June 17). Suicide. Who. Int. https://www.who.int/news-room/fact-sheets/detail/suicide