STANDARDIZING GUIDELINES FOR THE POST ADMINISTRATION OF THE GAD-7 SCREENING TOOL AT A VETERANS’ RESIDENTIAL FACILITY

ABSTRACTBrittney Bowman: Standardizing Guidelines for the Post Administration of the GAD-7 Screening Tool at a Veterans’ Residential Facility(Under the direction of Ann-Marie Jones)ProblemGeneralized Anxiety Disorder (GAD) is described as excessive worry that is uncontrolled and affects the functions of daily living. GAD is highly prevalent among U.S. adults, with rates increasing due to stressors such as the COVID-19 pandemic. Veterans, a vulnerable subgroup population of US adults, face an even greater risk of suffering from GAD due to pre-existing mental health conditions, social isolation, and economic instability. Veterans face unique risk factors that increase their likelihood of developing GAD, including combat exposure, PTSD, and challenges in transitioning to civilian life. PurposeThe purpose of this quality improvement project was to systematically incorporate the GAD-7 screening tool with a score-based notification algorithm based on the GAD-7 into every new intake appointment, at the Veteran’s Life Center in Butner, NC, aiming to facilitate early identification and intervention of generalized anxiety disorder and treatment. MethodsA 45-day intervention in which staff implemented an algorithm post-admission to a veterans’ facility included the administration of the GAD-7 screening tool upon admission to the Veterans Life Center. The nurse administered and scored the completed GAD-7, thus triggering the symptoms-related algorithm. The algorithm included how often the resident was seen by the NP and appropriate follow-up appointment scheduling.ResultsFollowing the implementation of the Post administration of the GAD-7 Screening Algorithm, data was collected on six veterans admitted to the veterans’ residential facility during the 45-day intervention period. All six veterans received their initial GAD-7 screening upon admission. In contrast to the retrospective cohort, 100% of these veterans received a documented H&P assessment within 10 days, reflecting a 50% improvement in timely initial evaluation. Additionally, the algorithm introduced a structured response protocol whereby elevated GAD-7 scores triggered chart flagging by nursing staff and prompted direct communication to the NP for clinical review.Discussion and Further ConsiderationsProject outcomes showed significant data improvement. Continued evaluation is needed to address and resolve the barriers to using a structured approach to recognizing and treating GAD according to Evidence Based Practice. With continued assessment and change, marked improvement and sustainability over time are achievable.