Date of Completion

Summer 2026

Document Type

DNP Scholarly Project

Academic Department

School of Nursing

Degree Type

Doctoral

Degree Name

Doctor of Nursing Practice

First Advisor

Dr. Sandra Cleveland

Second Advisor

Dr. Katie Hooven

Third Advisor

Dr. Adriane Stasurak

Abstract

Problem: Home-based adults aged 65 years and older receiving care at a community behavioral health center exhibited high psychotropic polypharmacy, with over 80% prescribed two or more psychotropic medications, exceeding The Center for Medicare and Medicaid services (CMS) guidance for safe use. This pattern heightened risks for adverse drug events, functional decline, and avoidable healthcare utilization, while exposing a practice gap characterized by underuse of non-pharmacologic interventions.

Aim of the Project: The Doctor of Nursing Practice (DNP) project aimed to determine whether integrating a structured Mindful Breathing and Meditation (MBM) program into routine services could reduce psychotropic medication burden and improve anxiety and depression outcomes over 12 weeks.

Review of the Evidence: Randomized trials and systematic reviews support MBM as a safe, feasible, and effective non-pharmacologic intervention that reduces anxiety and depression symptoms and can decrease reliance on psychotropic medications in older adults. Strong patient acceptance, high adherence, and sustained benefits beyond the intervention period support its adoption.

Project Design: This quality improvement project used a pre–post design guided by the Plan-Do-Study-Act (PDSA) framework and the OhioHealth Change Management Model to structure implementation, stakeholder engagement, and sustainability planning. Three PDSA cycles addressed appointment scheduling, reminder systems, and home-practice supports to optimize participation among home-based elderly patients.

Intervention: The intervention used a four-week MBM program, repeated twice, delivered as weekly 45-minute group sessions with structured daily home practice. Registered nurses led mindful breathing, seated meditation, and emotion regulation, while prescribers completed scheduled psychotropic medication reviews.

Significant Findings/Outcomes: Among 32 enrolled elderly home-based participants, 87.5% completed the eight-week MBM program; 46% of completers reduced or discontinued at least one psychotropic medication, yielding a 27% overall reduction from baseline. Mean anxiety and depression scores decreased by more than 30%, with no adverse events reported.

Implications for Nursing: The results show that nurses can safely and affordably add MBM to care as an adjunct to medications. DNP-prepared nurses can lead this work by building MBM into daily workflows and documentation, working with other providers to lower unnecessary psychotropic use, and regularly tracking outcomes to support value-based care.

Rights

Copyright, all rights reserved

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