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Doctor of Nursing Practice
Family Nurse Practioner
Year Degree Awarded
Month Degree Awarded
low back pain, military, spinal manipulation, toolkit, chiropractic
DNP Project Chair
DNP Project Member Name
DNP Project Outside Member Name
Background: Nonspecific Low Back Pain (NLBP) continues to be a frequent cause for medical care and creates significant direct and indirect costs for the patient and healthcare system. Military members are a unique patient population that is at increased risk for experiencing NLBP. Evidence supports spinal manipulation therapy (SMT) for the treatment of NLBP and clinical practice guidelines (CPG) recommend the use of SMT in the treatment of NLBP. Purpose: The purpose of this integrative review was to determine if SMT is an effective intervention for the military population experiencing NLBP. Presentation and Toolkit: An educational presentation and SMT Toolkit were created, formally presented, and distributed to providers that treat and manage active duty military. The SMT Toolkit is a comprehensive yet consolidated practice guide that includes current evidence, the CPG, local SMT referral options and criteria, provider resources, and patient education information. The DNP student created the SMT algorithm and patient education handout, which are embedded within the toolkit. Outcomes/Discussion: Based on the project’s outcomes, ultimately the integrative review with educational presentation, and SMT Toolkit succeeded in increasing providers’ knowledge and awareness and influenced their practice behaviors. Conclusion: The need to determine the most beneficial, conservative, and cost effective treatment options for NLBP like SMT is more important than ever. Users would benefit from using this DNP project, either through utilization in patient care, replication, or expanding further in a similiar quality improvement project. Future investigators should consider factors that improve utilization and sustainment of practice toolkits.