APRN Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in the College Population

Advanced Practice Registered Nurses (APRNs) treat students at the Student Health Service Center on the University of Utah Campus. The Nurse Scope of Practice includes ability of APRNs to diagnose ADHD. However, research reflects a wide diversity in reported comfort level in diagnosis and treatment of ADHD. The majority of all primary care providers report a need for additional training, not exclusive to APRNs. Undiagnosed or undertreated ADHD is detrimental to the academic success of the student. The purpose of this project was to increase the APRN comfort level in diagnosing and treating adult ADHD in the college population. A pilot education module containing background information on ADHD in the college population and best practice recommendations for diagnosis and treatment served to increase APRN knowledge within the primary care setting. Assessment of current comfort level and knowledge of APRNs in student health services about the diagnosis and management of ADHD in the college population was obtained through administration of a pre and post-survey to staff at SHS. Comparison of pre and post-survey aided in identifying altered trends in reported comfort level and knowledge regarding the diagnosis and treatment of ADHD. Project sustainability was achieved through incorporation of the module into new provider orientation. Additionally, education module posting to an electronic message board for student health services has been requested by other institutions. The literature demonstrates consistent estimated prevalence rates of ADHD in the adult population. Undiagnosed or untreated ADHD leads to reduced rates of graduation, increased rates of job termination, sexual partners, pregnancy, sexually transmitted diseases (STDs), and motor vehicle accidents. College students with a diagnosis of ADHD demonstrate a lower overall GPA at nearly 0.5, increased frequency of academic probation, increased course withdrawal or drop rates, and increased gaps in attendance. Reported barriers to care in the diagnosis and management of ADHD is the time providers must allow for ADHD patient assessments and monitoring, the lack of time allocated for thorough assessments, knowledge of available assessment tools, and low level of comfort. A primary care practice at the student health services clinic at a local university was selected for implementation and the education module was presented to the staff. A pre-module survey was administered to primary care providers regardless of title. Current practice and knowledge of ADHD was be surveyed. After the presentation about ADHD, including relevant criteria for diagnosis and treatment based on the DSM-V criteria and evidenced-based practice, a postmodule survey was administered. The post-survey questionnaire included a second evaluation of comfort level on the initial questionnaire and the perceived benefit of the presentation. A statistical analysis revealed that APRN comfort with diagnosis and management was achieved.