Evaluation of the implementation of an online psychiatric nurse practitioner program for primary care nurse practitioners: Use of a Participatory Evidence-Informed (PEPPA-Plus) framework

Published:March 24, 2022DOI:


      • Online post-master’s PMHNP certificate programs can be efficient and effective in increasing access to mental health.
      • Nurse practitioners with education and certification in more than one population foci are likely to merge the competencies in practice.
      • Rural mental health care workforce retention can be achieved by recruiting nurse practitioners who are already committed to rural living.
      • Long-term sustainability requires competent educators to teach NP students how to identify and address health disparities, and monitor impact.


      To address a growing need for primary care nurse practitioners to provide mental health care, grant support was obtained to create an accelerated online post-master's psychiatric-mental health nurse practitioner (PMHNP) program. A participatory evidence-informed framework (PEPPA-Plus) was used to 1) evaluate the program structures and processes from the perspectives of program graduates, and within this context, to evaluate outcomes following graduation, and 2) to evaluate the impact of the program through the implementation of the dual nurse practitioner role. Approximately half (56%) of the graduates completed a 40-item web-based survey. Ninety-nine percent of those who had taken the PMHNP exam were certified as PMHNPs, 99% were dually certified as primary care NPs, 86% reported that their scope of practice had changed to include the delivery of more mental health care services, and 27% were providing both mental and physical health care in integrated care settings. The vast majority (90%) reported a moderate to very high level of confidence in their PMHNP competency, 60% were teaching psychiatric-mental health nursing as preceptors, educators, or new program directors and 29% were providing care in communities with <50,000 residents. Over half of the graduates were committed to staying in their current practice position for at least the next five years. These findings demonstrate the success of the online program in producing graduates who utilize dual NP competencies in practice, at least 25% of whom are treating populations in non-urban settings, in integrated care settings, and treating populations with high social and environmental risk factors.


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