An Advanced Practice Nursing Protocol for the Standardization of Evidence-Based Heart Failure Education in the Primary Care Setting: A DNP Quality Improvement Project
MetadataShow full item record
Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
Problem: Thousands of Americans are diagnosed with and affected by heart failure, a chronic disease that is characterized by periods of exacerbations and remissions. Provision of effective and understandable education about self-management strategies is often sub-optimal in the primary care setting which can contribute to suboptimal patient outcomes, including increased hospitalizations, exacerbation of symptoms, and poor quality of life. Purpose: This DNP quality improvement project developed and evaluated the feasibility and acceptability of implementation of a new primary care-specific heart failure self-management practice protocol. This protocol provided evidence-based guidelines coupled with a practical tool for use by primary care nurse practitioners to deliver standardized heart failure education to their patients. The development and iterative refinement of the protocol was completed in collaboration with the clinic staff. The proof-of-concept implementation of the protocol was evaluated for feasibility and acceptability via a Usability, Usefulness, and Desirability (UUD) survey by the primary care practitioners and clinic staff, as well as ongoing dialogue via clinic staff meetings. Findings: All mean scores for individual UUD survey items exceeded the 4.0 minimum mean score identified as the benchmark for project success on the UUD 1 – 5 rating scale, with one exception for the item, "The activities in the tool are not relevant to my patients." Each UUD subscale (usability, usefulness, and desirability) mean response also exceeded 4.0 (means of 4.23, 4.53, and 4.66), supporting that the nurse practitioners and other clinic staff perceived the heart failure education tool and its implementation process in the clinic as highly usable, useful, and desirable. Field notes recorded throughout the implementation process included positive feedback regarding the tool and some specific suggestions for future work to enhance the format and delivery of the tool specific to the clinic workflow and patient subpopulations. Conclusions: The protocol was successfully implemented and favorably evaluated by the clinic staff. Future work will further refine the format and delivery of the tool for sustainability in the clinic in relation to staff suggestions for specific next steps.
A five-year embargo was granted for this item.
Items in Knowledge Bank are protected by copyright, with all rights reserved, unless otherwise indicated.