Doctor of Nursing Practice Program

Tara Duffie, DNP, MA, MSN, PMHNP-BC

Tara Duffie
  • Committee Chair Name & Credentials:
    Dawn Vanderhoef, PhD, DNP, PMHNP-BC
  • Committee Member Name & Credentials:
    Christian Ketel, DNP, RN, FNAP


DNP Project Abstract

Barriers to Metabolic Monitoring of Antipsychotic Medications in an Integrated Care Clinic

Second generation antipsychotic medications (SGAs) carry both short-term and long-term side effects of metabolic side effects. The current problem addressed by this project are provider perceived barriers to adherence to the guidelines for monitoring of metabolic side effects for SGA medications. The purpose of this project was to assess providers perceived barriers to monitoring of SGAs and conduct an educational intervention on the monitoring of SGAs.

REDCap was utilized to administer pre and post educational intervention surveys. Providers were surveyed about barriers to metabolic monitoring of SGA medication. Utilizing the pre-survey data an educational intervention was held to provide training on evidence-based practice for metabolic monitoring. Clinical patient data of those patients prescribed SGAs within the clinic was collected from the EMR to establish current baseline adherence to clinical practice guideline.

100% of providers were unaware of the current clinical practice guidelines for metabolic monitoring of SGAs. Most providers felt that SGAs should be monitored. Most providers reported patients being seen telehealth only as the most significant barrier to monitoring.

Implications for Practice
This project was a quality improvement project developed to assess provider perceived barriers to adherence and to provide an educational intervention based upon metabolic monitoring guidelines to promote adherence to these guidelines. Despite having evidence-based practice guidelines when patients are treated on SGAs poor adherence to the recommendations continue (Mitchell et al., 2012). Improved rates of metabolic monitoring according to the established NCQA guidelines in patients prescribed SGA medications aid in mitigating or reducing long-term side effects of SGAs.