University of Missouri - Saint Louis

The Graduate School


An oral examination in defense of the final project for the degree

Doctor of Nursing Practice

Kara J. Stackley
M.S. in Nursing, August, 2010, University of Missouri-St. Louis
B.S. in Nursing, August, 2008, University of Missouri-St. Louis
A.S. in Nursing, May, 1997, Jewish Hospital College of Nursing, St. Louis

The Feasibility of an Advanced Practice Registered Nurse-Managed ADHD Center in Missouri


The primary objective of this project was to develop a survey to determine provider receptiveness to referring patients to an advanced practice registered nurse-(APRN) managed center for the diagnosis and management of Attention Deficit/Hyperactivity Disorder (ADHD). A secondary aim of this project was to develop a business plan for the center, provided feedback from the survey was determined to be supportive. Physicians were more likely to use ADHD clinical guidelines (65%) in their practice and expressed greater comfort managing ADHD. Only 50% of APRNs use the clinical practice guidelines and 50% reported they were uncomfortable diagnosing and managing ADHD. Almost 70% of physicians and 100% of APRNs expressed a willingness to refer to an ADHD specialty center. However, when asked if they would refer to an APRN-managed ADHD specialty center, those percentages fell to 33.3% for physicians and 87.5% for APRNs. Since there was insufficient community support for this type of center, a business plan for the center was not developed.

Despite the professional advance of APRNs in recent years, further work is needed. Research should be done to establish why clinical practice guidelines are not being used consistently to diagnose and manage ADHD in this group and to further explore APRNs’ discomfort diagnosing and managing ADHD. Finally, further work is needed to explore and explain the finding that physicians in this sample expressed a willingness to refer to an ADHD specialty center for the diagnosis and management of ADHD, but not to a center managed by an APRN.


Date: November 12, 2012

Time: 11:30am 1:30pm

Place: College of Nursing Administration Building, Conference Room 1


Defense of Final Project Committee


Dawn Garzon, Ph.D.(Advisor)

Susan Kendig, J.D.


Shelly Hanko, Ph.D.

Angela Ames-Powers, MSN