DNP Essentials

Skills developed

During my DNP program, I have improved the following skills

Team player
Critical thinking and leadership
Effective communication
Interprofessional Partnership
Strong Patient advocate and Health Policy
Active Listening
Patient's integrity, dignity and respect

DNP Project

Screening for Depression before and after amputation among patients with diabetic foot ulcers

AbstractPatients with diabetic foot ulcers are at a higher risk of amputations. Amputations that occur due to complications of diabetes can be devastating to the patient and family members. This is because the patient is at a higher risk of developing depression. Despite the advanced development of sophisticated prosthetics and modern rehabilitation facilities to manage amputations, a significant population of diabetic patients with major amputations still finds it difficult to cope and adapt to the change in physical condition. 

Current literature indicates that early screening for depression among diabetic patients before and after amputations is highly critical as the patients are at high risk of suffering from depression. Unfortunately, this population of patients are often not screened for depression during routine outpatient clinic appointments. The lack of screening among this group of patients has resulted in poor diagnoses of depression. As a result, they experience poor quality of life, increased emotional and behavioral problems, premature death.

Project Implementation, Results & Findings

  • Clinical staff training on PHQ-9, depression, and algorithm
  • Qualtrics software was used to send surveys to staff to gather responses on the beliefs and attitudes of the implementation
  • PHQ-9 handed to patients to find their level of depression
  • The results were analyzed to determine if the implementation was successful

System usability scale (SUS) is a ten-item scale with a score range between 0 and 100
Qualtrics software was used to send emails to staff to gather responses about the SUS
The results were analyzed to determine if the implementation was successful.

The sample population of patients who completed the PHQ-9 was 59
The African American population had a 22.2% of severely depressed patients before amputation.
39% suffered from moderately severe depression
27% of the Caucasian population suffered from severe depression
67% of clinic staff responses indicated that they are more knowledgeable on the use of PHQ-9 tool to screen for depression
78% of the clinic staff agreed that the depression algorithm was easy to follow after completion of the PHQ-9 depression screening tool.

Project Dissemination

I disseminated my project at the Association of Clinicians for the Underserved 2023 annual conference that was held on July 24th and 25th, 2023 in Washington DC.

During this conference, I highlighted the importance of screening for depression among patients with chronic diabetic foot ulcers facing amputations. 

Research indicates that the underserved population is significantly affected by diabetic complications such as diabetic foot ulcers. The rate of amputations is nine times higher among African Americans due to vascular-related diseases such as Diabetes (The Office of Minority Health, n.d).  Evidence-based research indicates that lower extremity complications due to diabetic foot ulcers negatively affect a person’s quality of life and this makes the person vulnerable to psychiatric symptoms such as depression (Kizilkurt et al., 2020).

Project Presentation Highlights

Background: Patients with chronic diabetic foot ulcer are at risk for a major amputation.

An estimated 73,000 lower limb amputations occur every year because of diabetes foot ulcers 

These population of patients are at substantial risk of developing depression over time

Problem statement: Unfortunately, these patients are not screened for depression during routine foot clinic visits. 


What my colleagues say

Osita is my coursemate at George Mason University. He is dedicated and devoted to his studies. He is intelligent and always willing to learn. He also maintains a high level of professionalism and respect for others.
I have known Osita for the last four years. He has been my coworker since then. He is very friendly and always willing to help. Osita is knowledgeable in his field. He provides compassionate care to all his patients. He is also very empathetic, punctual, eager to learn, and sets high standards for himself.
Arati Parajuli RN

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