Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences



Major Advisor



People who have severe mental illness are known to experience comorbidities and have shorter lifespans than those in the general population. There are many confounding reasons for those in this population to experience comorbidities that shorten their lives. However, it is commonly recognized that metabolic changes caused by medications taken to treat severe mental illness play a major role in the development of comorbidities and early mortality in those who take them. Drug manufacturers and several major organizations recommend the close monitoring of the metabolic status of those prescribed drugs in the class of medications known as antipsychotics. However, literature suggests that metabolic monitoring guidelines are rarely followed. This project explores the role nurses can take to better monitor the metabolic status of those taking antipsychotic medications. With increased monitoring, prescribers have a clearer picture of the client’s metabolic status, can be better aware of changes that may occur during initiation and continuation of treatment, and the opportunity to make interventions that lead to better health outcomes. This document describes a process improvement project designed to increase metabolic monitoring among Veterans newly prescribed an antipsychotic medication by providing a nurse case manager, working with a pharmacist, to assist with the metabolic monitoring process. The project is known as the Metabolic Ounce of Prevention. The setting is a mid-south Veterans Administration Medical Center [VAMC] and its outpatient mental health clinics.

Available for download on Thursday, July 18, 2024