Date of Conferral

2015

Degree

Doctor of Nursing Practice (DNP)

School

Health Services

Advisor

Mercy Popoola

Abstract

Osteoarthritis (OA) is a debilitating chronic illness that can prevent older adults from accomplishing their activities of daily living or ambulate without pain. The project's purpose was to develop and disseminate multidisciplinary educational practice guidelines to nurses for use in older homebound male Veteran's Administration OA patients to improve home-based pain management and self-care preventative strategies. Orem's theory of self-care management constituted the theoretical framework. The design was a quality improvement project and involved formation of 6 panels of interdisciplinary teams who reviewed the American Society of Anesthesiologist (ASA) and Osteoarthritis Research Society International (OARSI) guidelines. The ASA and OARSI guideline components were evaluated via a scoring sheet for pain control and self-management effectiveness for the OA patient. The panels assessed these treatment plans in terms of suitability, tolerance, and patient adherence for inclusion into the educational program. The panel members independently reviewed both sets of guidelines and then convened as a group to share their scores and reach a consensus on these guidelines, in the patient population served. Agreement of 85% among the panel members was needed for inclusion into the practice guideline. Based on the scoring results the panel concluded that the ASA and OARSI guidelines would likely improve pain control, functional ability, and psychological well-being essential to lifestyle modifications and OA symptoms management education program. The social impact of developing nursing practice guidelines for the self-management of OA pain in home-based settings will be manifested in better patient lifestyle and behavior modification leading to better symptom management.

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