Date of this Version
7-31-2025
Document Type
DNP Project
Abstract
Abstract QTc prolongation is a significant clinical concern among psychiatric patients prescribed psychotropic medications, as it increases the risk for life-threatening arrhythmias such as torsades de pointes and sudden cardiac death. Despite these risks, standardized protocols for electrocardiogram (ECG) monitoring in the outpatient psychiatric setting remains inconsistent. This Doctor of Nursing Practice (DNP) quality improvement project aims to implement a validated, evidence-based QTc Prolongation Risk Assessment Template—specifically, the Tisdale QT Risk Assessment Tool—at Recovery From Society (RFS) Psychiatry in Tampa, Florida, to enhance systematic ECG monitoring and informed clinical decision-making. Guided by the Health Belief Model, the intervention consisted of structured provider education, integration of the tool into the electronic health record (TherapyNotes), and follow-up surveys that assessed provider confidence, intent to implement, and the tools usability. The postintervention survey responses revealed high satisfaction with the training, increased provider confidence, and strong intent to incorporate the tool into practice. A large effect size (Cohen's d = 1.03) further supported the clinical significance of the intervention. RFS Psychiatry staff identified barriers, such as time constraints and patient adherence, feedback that can be used for future quality improvement initiatives for QTc monitoring. Despite the projects limitations, including a small sample size and the absence of a control group, this project demonstrates the value of integrating standardized QTc risk assessment protocols into outpatient psychiatric care. Sustainability efforts include continued training, workflow integration, and administrative oversight. This project highlights the leadership role of advanced practice nurses in promoting safe prescribing practices, standardizing care, and enhancing patient outcomes through evidence based practice.
Recommended Citation
Williams, Alexis Sheree; Grana, Dr. Antonella; Jordan Jr., Dr. Craig; and Sanchez, Dr. Michael, "Implementing a QTc Prolongation Risk Assessment Template for ECG Monitoring in Patients on Psychotropic Medication: A Quality Improvement Project" (2025). Nicole Wertheim College of Nursing Student Projects. 353.
https://digitalcommons.fiu.edu/cnhs-studentprojects/353