Outcome Evaluation of an Evidence-based Quality Improvement Initiative to Integrate Health and Wellness Coaching in Advanced Nursing Practice

Abstract

Chronic diseases linked to lifestyle behaviors are the leading causes of preventable morbidity and mortality in the United States (Centers for Disease Control and Prevention, 2017). To provide effective prevention and management of chronic illness requires clinicians to motivate individuals to achieve self-determined goals and to sustain healthy lifestyle behaviors, and yet studies document that about 25% of providers do not have adequate knowledge and skills to create effective partnerships (Bos-Touwen, Trappenburg, van der Wulp, Schuurmans, & de Wit, 2017; Greene, Sacks, Hibbard, & Overton, 2017). Providers who use health and wellness coaching techniques in practice can enhance motivation, improve well-being, and bridge the gap between recommendations and behavior change (Clark et al., 2014; Lawson et al., 2013; Mettler et al., 2014; Smith et al., 2013). The purpose of this DNP project was to evaluate how family nurse practitioners (FNPs) perceive their ability to use health and wellness coaching techniques in clinical practice after participation in an evidence-based quality improvement (EBQI) initiative to understand and implement coaching skills. Three consecutive cohort groups of FNP students completed a coaching program during the final year of their educational program. An outcome evaluation was completed using an online survey to report their perceptions and confidence in supporting patient self-management. Survey respondents reported use and effectiveness of coaching techniques, and agreed that the coaching initiative caused them to consider their own wellness. This DNP project informs subsequent EBQI efforts intended to impact clinician ability to offer effective support for health, wellness, and self-management of chronic disease. Next steps include addressing how coaching can be implemented for specific populations, including but not limited to those with obesity, heart disease, and/or mental health disorders like depression.