Doctor of Nursing Practice (DNP) Projects

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Embargo Period

4-25-2017

Degree Program

Doctor of Nursing Practice

Degree Track

Family Nurse Practioner

Year Degree Awarded

2017

Month Degree Awarded

May

Keywords

pulmonary rehabilitation, COPD, provider education, quality improvement

Advisor Name

Anna

Advisor Last Name

Paskausky

Capstone Chair First Name

Anna

Capstone Chair Last Name

Paskausky

Capstone Member Name

Jean

DeMartinis

Capstone Outside Member Name

Kristin

McCarthy

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a chronic and debilitating disease from which 9% of the population suffers (CDC, 2013). Pulmonary rehabilitation (PR) is a well-documented evidence-based intervention for patients with chronic respiratory diseases, leading to better health outcomes for patients; however, PR is grossly underutilized in primary care (Rochester et al., 2015). Providers face many barriers which cause this gap between the evidence and clinical practice, such as a lack of understanding of the rehabilitation program and insurance coverage (Rochester et al., 2015).

Purpose: The aim of this Doctor of Nursing Practice (DNP) project was to launch a quality improvement (QI) initiative to improve discussions and referral rates of patients with COPD to pulmonary rehabilitation.

Methods: This project was influenced by Kurt Lewin’s theory on organizational change. The design used Lewin’s unfreezing, moving, and refreezing to change the care of COPD patients. This project used a provider focus group, a provider educational session, and reminder systems to track pulmonary rehabilitation discussions and referrals at a primary care office in Athol, Massachusetts over four months.

Results: Prior to this intervention, the providers had not discussed pulmonary rehabilitation or placed any referrals to in the previous two years. After the educational session, providers had 20 discussions with patients about pulmonary rehabilitation, which lead to four referrals.

Conclusion: This DNP project improved provider’s knowledge and understanding of pulmonary rehabilitation and was associated with an increase in the number of discussions about and referrals to pulmonary rehabilitation.

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