Date of Completion
Fall 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Dr. Kristie Lowry
Second Advisor
Dr. Melanie Brewer
Abstract
Problem: Tardive dyskinesia (TD) and extrapyramidal symptoms (EPS) are potential adverse effects of long-term antipsychotic use that require ongoing monitoring. At the project site, inconsistent staff education, a lack of a standardized screening process, and the absence of electronic health record (EHR) reminders contributed to missed Abnormal Involuntary Movement Scale (AIMS) screenings. Baseline screening compliance was 54.7% (106/194).
Aim of the Project: The aim of this quality improvement project was to increase AIMS screening compliance among adult patients receiving long-term antipsychotic therapy from a baseline of 54.7% to 90.7% within 12 weeks.
Review of the Evidence: Literature review has shown that using a standardized screening tool, educating clinicians, documenting screening consistently, and utilizing EHR reminders will enable providers to monitor for abnormal movements and identify those that may require intervention.
Project Design: The Institute for Healthcare Improvement (IHI) Model for Improvement guided the project. Plan-Do-Study-Act (PDSA) cycles supported ongoing evaluation and refinement. The OhioHealth Change Management Model supported staff engagement and adoption of the practice change. EHR chart audits, percentages, and weekly run charts were used to evaluate performance.
Intervention: Providing education to staff members on how to perform the AIMS screen and document it properly. Implemented a new EHR template and reminder to prompt clinicians. Chart audits were conducted to review whether screenings were completed and to provide staff with feedback. Continue to educate staff on the importance of using the standardized screening tool.
Significant Findings/Outcomes: Following implementation, AIMS screening compliance increased from 54.7% (106/194) at baseline to 90.7% (108/119), representing a 36.0-percentage-point improvement and a 65.8% relative increase. Weekly monitoring showed continued improvement and helped identify areas requiring reinforcement.
Implications for Nursing: This project demonstrates how a simple, standardized approach can strengthen medication safety and improve consistency in psychiatric practice. The project supports the IHI Triple Aim by promoting population health, improving the patient experience through consistent monitoring, and potentially reducing costs associated with delayed recognition of medication-related adverse effects. It also addresses the Institute of Medicine’s Six Aims, particularly safety and effectiveness. Standardized AIMS screening reinforces nursing’s role in evidence-based practice, medication monitoring, and early identification of adverse effects.
Recommended Citation
Lovelace, Jeriece, "Improving Abnormal Involuntary Movement Scale Screening Consistency in Outpatient Psychiatric Practice" (2026). All Doctor of Nursing Practice (DNP) Scholarly Projects. 85.
https://fuse.franklin.edu/dnp-project/85
Rights
Copyright, all rights reserved
