Doctor of Nursing Practice (DNP) Projects

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Family Nurse Practioner

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Borderline personality disorder, Dialectical Behavior Therapy, referral in primary care, mental health statistics


Dr. Donna Sabella M.Ed., MSN, PhD, RN, PMHNP-BC

DNP Project Chair

Dr. Donna Sabella M.Ed., MSN, PhD, RN, PMHNP-BC



Background: Borderline personality disorder (BPD) is a psychiatric disorder that falls into the Cluster B personality disorders, per the DSM-5. Borderline personality disorder is described as a disorder that follows a path of regular emotional instability and detrimental interpersonal relationships. Individuals who are diagnosed with borderline personality disorder are often found to be difficult to manage and treat from a primary care perspective.

The purpose of this project was to increase the awareness of primary care Nurse Practitioners (NPs) about BPD in order to increase their knowledge about BPD and provide continuity of care in a primary care setting for patients with this disorder.

Methods: The sample consisted of 18 NPs who practiced in New York State, or were recruited using the Massachusetts Coalition of Nurse Practitioners. An education toolkit, developed by the National Institute of Mental Health which provided information about BPD, including signs and symptoms, was emailed to primary care NPs. A pretest, followed by a review of the toolkit module, was then followed by a post-test. The pre and post-tests measured the knowledge level of NP primary care providers in recognizing symptoms of borderline personality disorder.

Results: 18 NPs were tested in 3 categories relating to BPD which included familiarity of symptoms, their overall knowledge of the disorder, and their comfort at diagnosing the disorder. The results were compared between the pre-test and the post-test after reviewing the education module. At the end of the project, the NPs scores in familiarity of symptoms increased by 68.4%, overall knowledge increased by 70% and overall comfort increased by 45.5%.

Conclusion: The original goal of the project was to have an overall knowledge increase by at least 25% in the three measured categories relating to BPD. The percentage increases in the three categories exceeded the goal of 25% between the pre and post-test. Therefore, increasing awareness and education about BPD in those surveyed resulted in an overall knowledge gain about the disorder and overall increase in mental health awareness.

- Keywords: Borderline personality disorder, Dialectical Behavior Therapy, fragmentation of care, referral in primary care, Borderline personality disorder suicidality, Borderline personality disorder medication, mental health statistics

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