Date of Award

Fall 2023

Project Type

Clinical Doctorate

College or School




Program or Major

Doctorate of Nursing Practice

Degree Name


First Advisor

Angela M. Braswell

Second Advisor

Tomeka Royster

Third Advisor

Cathleen Colleran



In this quality improvement project, I aim to enhance the knowledge and confidence of psychiatric mental health nurse practitioners (PMHNPs) in completing Decisional Capacity Mental Assessments (DMCAs). I use qualitative and quantitative methods to measure the intervention’s success, emphasizing PMHNPs’ role in ensuring ethical DMCAs while maintaining patient autonomy. The education-based intervention significantly improves PMHNPs’ knowledge and confidence levels following the pre-education survey. These findings highlight the significance of DMCA training for health-care professionals, underscoring the necessity of standardized assessments alongside improved dialogue during capacity evaluations. Limitations include limited sample sizes and dependence on self-reported measures, which may introduce bias. Using the MacArthur competence assessment tool exclusively may limit the applicability of outcomes to broader contexts. The program shows the PMHNPs at Veterans Affairs medical centers, but contextual factors decide their effectiveness. Examining broader gains beyond knowledge and confidence, such as alterations to clinical protocols or cross-functional collaboration, is critical. To ensure program longevity, the VAMC must cultivate an environment conducive to learning and integrate policies; collaboration among medical experts is crucial. PMHNPs will be able to perform accurate DMCAs while adhering to patient rights and ethical decision-making practices. In future explorations, researchers must delve into persisting impacts on patient satisfaction rates and legal consequences, thus ensuring continued training, particularly employing the MacArthur Competence Assessment Tool-Treatment.