Date Available

5-6-2021

Year of Publication

2021

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Julianne Ossege

Clinical Mentor

Jessica Sass

Committee Member

Dr. Lynne Jensen

Committee Member

Dr. Elizabeth Tovar

Abstract

Background: Nurses with a Doctor of Nursing (DNP) degree are prepared at the highest level of expertise to provide safe and efficient health care to patients and help bridge the gap between research and evidence-based health care. Although DNP students invest significant effort, time and resources to implement quality improvement (QI) projects, the sustainability of the outcomes of these is not well studied and empirical evidence on sustainability of quality improvement interventions is very limited.

Objective: To assess the sustainability of the QI project titled: “Using Rapid Cycle Improvement to Improve Weight Management” over time and evaluate the characteristics of the clinic associated with the sustainability of the QI project.

Methods: This is a single-center, descriptive study to assess the sustainability of the QI project at a Family Medicine and Community Clinic in 2018. To examine the rates of intervention sustainability, data was obtained from the EHR for all patients seen at the clinic in November 2020. Additionally, qualitative data was collected through staff surveys to identify the contextual factors associated with the sustainability of the QI project using the Practical Robust Implementation and Sustainability Model (PRISM) framework as a guide.

Results: Quantitative data showed that BMI screening and weight management documentation was 30.0 % (2019) and 30.8% (2020) which is lower compared to the rates at the end of the QI project in 2018 (33.89%) and the goal of 65% for reimbursement purposes. Although the rates remain low, the practice of BMI screening and weight management is sustained at this setting. Multiple factors including importance of practice, knowledge of intervention and administrative support were identified as facilitator by nursing staff, while time constraint was the main barrier identified by providers to complete weight management documentation.

Conclusion: Study findings indicate that although BMI screening and weight management documentation is sustained at a Family Medicine and Community Clinic, the initial implementation efforts of increasing the rates of this intervention by the previous DNP project are not reached. Associated contextual factors identified by this study should be considered by the clinic leaders and future researchers to implement further interventions to improve the rate of BMI screening and weight management documentation in this setting.

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