Graduation Year
2025
Degree Type
Open Access Capstone
Document Type
Capstone
Degree Name
Doctor of Nursing Practice (DNP)
Department
Baccalaureate and Graduate Nursing
First Advisor
Linda Hunter
Department Affiliation
Baccalaureate and Graduate Nursing
Second Advisor
Fontaine Sands
Department Affiliation
Baccalaureate and Graduate Nursing
Department Affiliation
Baccalaureate and Graduate Nursing
Abstract
Abstract
Tardive dyskinesia (TD) is a potentially irreversible movement disorder linked to long-term antipsychotic use and remains insufficiently detected in outpatient settings due to inconsistent screening. This Doctor of Nursing Practice quality improvement project aimed to improve early TD recognition by implementing a clinical behavioral change to monthly Abnormal Involuntary Movement Scale (AIMS) assessments for adults prescribed antipsychotics. Using the Plan-Do-Study-Act organizational framework, seven clinicians were trained with brief, evidence-based multimedia modules and assessed 60 patients over eight weeks via in-person or telehealth visits. Pre- and post-intervention surveys evaluated adherence to AIMS guidelines, provider confidence, and training perception. Dr--identified electronic health record aggregate data from the preceding eight weeks was used to compare TD detection rates, documentation completion, and helped to verify alignment with the literature sources. The resulting data showed a significant increase in TD detection from 2.8% to 16.67%, with 100% adherence to monthly assessments, and 99.17% documentation rates. Pre and Post AIMS guideline adherence showed a strong correlation (p = .035) and demonstrating significant improvement in adherence. Cohen’s d of 0.39 suggests a small to moderate effect translating to a measurable behavioral change in screening. Higher training ratings aligned with greater confidence and adherence. Histogram data showed improved distribution and behavioral change consistent with project goals. The findings support the behavioral change resulting from structured screening and provider education as effective strategies for improving TD detection in outpatient settings.
Keywords: Abnormal Involuntary Movement Scale (AIMS), antipsychotic, clinician, drug-induced, quality improvement (QI), tardive dyskinesia (TD), telehealth
Copyright
2025 Edward Graham
Recommended Citation
Graham, Edward, "Optimizing AIMS Assessments: An Evidence-Based Initiative for Outpatient Tardive Dyskinesia Identification" (2025). Doctor of Nursing Practice Projects. 123.
https://encompass.eku.edu/dnpcapstones/123
IRB Approval Number (if applicable)
IRB Protocol Number: 6348
