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Date of Award

5-14-2012

Degree Type

Restricted Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Christine P. Kurtz

Abstract

Attention-Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder causing inattention, hyperactivity and impulsivity beginning in childhood and often continuing with impairment into adulthood (Barkley, 2008). Treatment of adults with ADHD is controversial and a lack of consensus for treatment abounds in the United States. There are currently no clinical guidelines in the United States guiding treatment of ADHD in adult patients. The lack of guidelines and consensus among healthcare professionals can lead to improper and ineffective management of the disorder due to inconsistency in practice. An evidence-based practice project was developed and implemented at a community mental health center located in north central Indiana to guide practice for diagnosis and treatment of adult ADHD. The Stetler model of research utilization was used to guide the project. Best-evidence obtained through an extensive review of literature was used to develop an algorithm for treatment of adults with ADHD. To determine project effectiveness, a chart-audit tool was developed to measure pre- and post implementation of the algorithm. After organizational approval for the project was secured, a pre-implementation chart audit was conducted. Education regarding the algorithm was provided to psychiatrists and psychiatric advanced practice nurses of the center. The adult ADHD algorithm was implemented for a ten-week period. A post-implementation chart-audit was conducted on all adults treated for ADHD during the ten-week period. Outcomes were evaluated using the SPSS 20.0 statistical package. Data was analyzed using chi-square of independence and independent t tests to determine the effectiveness of the algorithm. The chi-square and independent t tests demonstrated effectiveness of the adult ADHD algorithm for improving consistency of practice at the mental health center

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