College of Nursing and Health Sciences DNP Defense - Jonadab Erhahon, MSN, RN, PMHNP
Title: Enhancing Staff Knowledge and Confidence in the Management of Behavioral and Psychological Symptoms of Dementia (BPSD): A Quality Improvement (QI) Initiative
Student: Jonadab Erhahon, MSN, RN, PMHNP
Faculty Mentor: Mark Adelung, PhD, RN, CPH
Committee Member: Kristopher Jackson, PhD, MPH, AGACNP-BC, CNE, FAANP
Clinical Site Mentor: Katina Herron, MSN, NP-C
Date: 4/29/2026
Time: 9:00AM
Zoom: Please contact dhoffman@umassd.edu for link.
Abstract
Background: Behavioral and psychological symptoms of dementia (BPSD), including agitation, aggression, anxiety, and wandering, are prevalent among nursing home residents and pose significant care challenges. Although nonpharmacological interventions are recommended as first-line management, antipsychotic medications remain widely used despite associated risks. At Victory Nursing Home, reliance on these medications highlighted the need to strengthen staff competency in nonpharmacological approaches.
Purpose: The purpose of this quality improvement (QI) project was to evaluate whether a structured educational intervention could improve nursing home staff knowledge and confidence in the nonpharmacological management of BPSD.
Methods: A single-group pretest–posttest design was used with 34 nursing home staff (RNs, LPNs, CNAs, and activities personnel). Participants completed the Dementia Knowledge Assessment Tool (DKAT) and the Confidence in Dementia (CODE) scale before and after an educational program focused on communication strategies, environmental modifications, and person-centered care. Data were analyzed using descriptive statistics and paired-samples t-tests, with qualitative feedback analyzed using content analysis.
Results: Statistically significant improvements were observed in both knowledge and confidence following the intervention. Mean DKAT scores increased from 15.29 to 18.56 (p < .001), and CODE scores increased from 34.21 to 41.50 (p < .001). Qualitative findings indicated increased confidence in applying strategies such as validation, redirection, and environmental modification, while also identifying barriers including staffing constraints and limited time.
Conclusion: A structured educational intervention effectively improved staff knowledge and confidence in nonpharmacological management of BPSD. Strengthening staff competency in person-centered dementia care may help reduce reliance on antipsychotic medications and improve resident outcomes. Continued organizational support is needed to sustain practice change.
Zoom
Deanna Hoffman
dhoffman@umassd.edu