Implementation of an Anxiety Screening and Treatment Protocol in Primary Care

Background: Anxiety is a prevalent problem frequently presenting in the primary care setting in the United States. The lack of routine anxiety screening and evidence-based treatment protocols in the adult primary care setting causes physical, social, and economic consequences. Purpose: The purpose of this Doctor of Nursing Practice (DNP) evidence-based practice (EBP) quality improvement project was to implement an EBP anxiety screening and treatment protocol for adults in a primary care clinic to increase early identification and improve management of generalized anxiety disorder (GAD). Theoretical Framework: W. Edwards Deming’s Plan-Do-Study-Act (PDSA) cycle framework was utilized for this project. The PDSA outlines the necessary cycles of how to effectively identify, develop, implement, analyze, and sustain quality improvement practice changes in an organization. Methods: Descriptive statistics and Pearson’s r were used for this retrospective/prospective chart review design. Results: Findings are clinically significant and demonstrate 69.07% of post-implementation prospective charts utilized the generalized anxiety disorder 7-item (GAD-7) screening tool to screen for GAD, which quantified an anxiety level, and can be utilized to prescribe EBP treatment for adults with GAD in primary care. Conclusion: Although findings of anxiety score correlating to EBP treatment were statistically insignificant, further studies are necessary to determine if obtaining an anxiety level results in the provider making changes to preexisting treatment plans that align with EBP treatment in adults with GAD.