Date of Conferral

2-9-2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Barrett

Abstract

The Doctor of Nursing Practice (DNP) project was a staff education program aimed at addressing the current practice of unimodal spinal manipulation therapy (SMT) in an outpatient chiropractic clinical practice, which has shown poor long-term patient effects of persistent pain and opioid dependence. Staff members’ limited understanding of multimodal approaches to managing chronic low back pain (CLBP) leads to the practice gap. To address the problem, an educational program that incorporated standardized multimodal pain management strategies for adult patients with CLBP was developed. The project sought to address whether structured evidence-based training on multimodal pain management would increase the knowledge of chiropractic staff in the clinical setting. Staff knowledge was assessed using a pre- and posttest format. Descriptive statistics were used to analyze the project data. Project success was seen in the measurable improvement in participant pre- and post-test scores and in the positive responses gleaned from participants’ evaluation of the program. Project results revealed significant improvement in staff knowledge on compliance with multimodal protocols and clinical confidence. Key products included standard training modules that incorporated protocol, checklists, and electronic medical record (EMR) integration tools. Recommendations included providing continuous employee training, regular multidisciplinary meetings to ensure consistent implementation of multimodal CLBP care, and outcomes measurement. The project has the potential to enhance nursing practice through increased clinical competence, culturally centered care, and standardizing non-pharmacologic pain care interventions that also enhance diversity, equity, and inclusion with the potential for positive social change.

Available for download on Thursday, May 20, 2027

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Nursing Commons

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