Date of Award

Spring 5-31-2026

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Briony DuBose, PhD, MHI, RN, LSS BB

Abstract

Background: Tardive Dyskinesia (TD) is a debilitating, often irreversible movement disorder caused by prolonged exposure to dopamine receptor-blocking agents, affecting 15-30% of patients on long-term antipsychotic therapy. Despite endorsement of the Abnormal Involuntary Movement Scale (AIMS) as the gold standard for TD screening, the condition remains significantly under-diagnosed. Purpose: This quality improvement project evaluated whether a 45-minute educational intervention could improve PMHNP trainees’ confidence and competence in TD recognition and AIMS administration. Methods: Guided by the Iowa Model of Evidence-Based Practice, the project used a pre-post survey design with a planned one-month follow-up across two clinical training sessions. Ten PMHNP students and Fellows completed identical 5-item Likert-scale surveys covering TD pathophysiology, symptom recognition, differential diagnosis, APA guidelines, AIMS administration, pharmacological management, and clinical vignettes. An AIMS smart phrase was integrated into the electronic health record to support documentation. Results: Pre-intervention results revealed substantial gaps, with mean confidence in conducting AIMS assessments at 2.50/5.0 and 50.0% of participants reporting minimal confidence. Following the intervention, all five domains demonstrated meaningful improvements: overall mean scores rose from 3.04 to 4.13 (+36.0%), confidence in conducting AIMS rose from 2.50 to 4.00 (Cohen’s d = 1.32), and the proportion reporting low confidence (< 2) dropped from 50.0% to 0%. No responses were received at the one-month timepoint (0/10) despite multiple reminders, precluding analysis of sustained retention. Conclusion: A brief, structured TD educational intervention produced large-effect improvements in PMHNP trainees’ immediate confidence and competence, supporting integration of targeted TD screening education into psychiatric clinical training curricula.

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