| Description |
Background: Nutrition plays a crucial role in mental health, yet nutritional screening and education are often underutilized in outpatient mental health settings. Poor nutrition is associated with worsened psychiatric symptoms, while improved dietary habits can enhance overall mental well-being. Clinicians frequently face barriers to integrating nutritional guidance into patient care, including limited knowledge, time constraints, and a lack of standardized tools and resources. Local Problem: An outpatient mental health clinic in suburban Utah lacked a structured protocol for assessing and addressing patients' nutritional health. Clinicians expressed interest in integrating nutritional healthcare into their mental health practice but named several barriers, including limited education in nutrition, uncertainty about proper recommendations, and a lack of accessible resources. This Doctor of Nursing Practice (DNP) quality improvement project sought to implement and evaluate a nutritional screening and education toolkit designed to support clinicians in routinely addressing patients' nutritional needs as an essential part of comprehensive mental healthcare. By integrating evidence-based resources into clinical practice, the project aimed to enhance the quality of care and promote better health outcomes for individuals receiving mental health services. Methods: The project lead implemented a quality improvement initiative using the Johns Hopkins Evidence-Based Practice model and Plan-Do-Study-Act (PDSA) cycles. A pre-implementation survey assessed clinicians' knowledge, attitudes, and barriers to nutritional interventions. The project lead then integrated a nutritional toolkit-including a screening tool, a QR-accessible patient education document, and a listing of local registered dietitians-into the electronic health record (EHR). A post-intervention survey evaluated the feasibility and usability of the toolkit, as well as clinician satisfaction with the new workflow. This iterative process allowed for ongoing evaluation and refinement of the intervention to optimize its integration into clinical practice. Interventions: The project followed four phases: (1) conducting a pre-implementation survey and engaging stakeholders, (2) developing and integrating the nutritional toolkit, (3) refining the toolkit through iterative PDSA cycles, and (4) evaluating outcomes post-implementation. Clinicians received education during monthly staff meetings and through email updates. The toolkit emphasized practicality, requiring minimal additional appointment time while encouraging patient engagement with nutrition-related resources. Results: Of the 18 clinicians and staff at the clinic, 89% (n = 16) completed the pre-survey and 75% (n = 12) completed the post-survey. The pre-implementation survey showed that 90% (n = 14) of respondents recognized the impact of nutrition on mental health, yet only 46% (n = 6) frequently recommended nutritional changes to patients. Following the intervention, 56% of clinicians reported using the nutritional screening tool at least some of the time. Similarly, 56% discussed nutrition education materials with clients occasionally, 22% did so rarely, and 11% always engaged in this practice. Feasibility ratings were high, with 83% of respondents finding the screening tool somewhat to very feasible. All participants rated the toolkit's usability as fair to excellent, and 75% agreed that the intervention was acceptable. Conclusion: Clinicians in the outpatient mental health clinic found the nutritional screening and education toolkit to be feasible, acceptable, and usable. The intervention increased clinician confidence and engagement in addressing nutrition as part of holistic mental health care. These findings suggest similar strategies could be implemented in other outpatient settings to promote interdisciplinary collaboration and improve patient outcomes. Future projects should identify the long-term effects, address ongoing barriers, and evaluate the toolkit's effectiveness across diverse clinical environments. |
