Date of Award

Fall 2022

Project Type

Clinical Doctorate

College or School




Program or Major

Doctor of Nursing Practice

Degree Name


First Advisor

Pamela Wall

Second Advisor

Anthony Angelo

Third Advisor

Cathleen Colleran



The paper outlines a quality improvement project to improve clinicians' knowledge in using the Beck Depression Inventory (BDI) within an outpatient setting, known as the Assertive Community Treatment (ACT) team. The BDI is among the standard depression screening instruments used. The primary care version of the tool is preferred because it discriminates somatic symptoms that may overlap with other clinical conditions. Clinician knowledge and skills are critical to ensure appropriate scoring and interpretation of the scores. In this quality improvement (QI) project, the clinicians completed questionnaires to determine their BDI-related knowledge before (pre-test) and four weeks after (post-test) the training. Comparative analyses between pre-test and post-test findings identified knowledge changes (i.e., retention) achieved following the educational sessions. The program focused on administering, scoring, interpreting BDI scores, and safety planning for at-risk patients. The QI initiative comprised the deployment of the BDI tool, continuous training, and personalized coaching to improve compliance. Clinicians refined their knowledge and improved patient service quality. Patient record reviews determined that clinicians achieved the required competence and proficiency in using BDI based on the number of positive screens recorded. The one-tailed Wilcoxon signed-rank test was used to compare the improvements in knowledge. In contrast, Spearman's rho was used to assess the effect of provider experience and educational level on changes in knowledge. In conclusion, introducing provider training improved BDI-related knowledge, leading to improvements in the number of patients screened.

Keywords: Outpatient, primary care, safety, clinicians, knowledge, major depressive disorder,