Date of Award

January 2026

Document Type

Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Mary-Ann Cyr

Abstract

Pulmonary hypertension is an under-recognized, progressive, and potentially fatal disease. Thecurrent time from onset of symptoms to diagnosis is greater than two years, with the majority of patients being diagnosed in advanced stages of the disease (Didden et al., 2023). Meanwhile, the stage at time of diagnosis was found to be the strongest predictor of survival (Park et al., 2014). Earlier recognition is paramount to improving quality of life, while decreasing the economic burden, morbidity, and mortality that is associated with this condition. The crucial need for earlier screening of this disease is highlighted throughout the literature, however no intervention has been successfully implemented for all categories of pulmonary hypertension. Research has provided clinical characteristics, risk factors, and specific populations at greater risk for this disease. This DNP project aimed to use this information to develop a screening questionnaire that integrates into a decision tree to identify patients at risk of pulmonary hypertension and guide further diagnostic workup. This intervention was implemented on all patients, without a previous diagnosis of pulmonary hypertension, who presented to a private outpatient practice over the course of fourteen weeks. The number of patients who received a cardiology referral or echocardiogram to work-up suspected pulmonary hypertension and the number of positives, was compared to the number of patients diagnosed with pulmonary hypertension or referred during the same fourteen-week period of the prior year. The screening questionnaire and decision tree will be revised or adapted, based on evidence from the pilot, to make recommendations for sustainability and scalability.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 10/06/2028

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