Doctor of Nursing Practice (DNP) Projects
Title
Effect of Provider Education on Pulmonary Rehabilitation Referrals and Discussions with Patients
Access Control
Open Access
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
Anna Paskausky
DNP Project Chair
Anna Paskausky
DNP Project Member Name
Jean DeMartinis
DNP Project 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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