Date of Conferral

2017

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Catherine Garner

Abstract

Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of people 65 years and older. The rural health clinic failed to capture a single AWV in the previous year, despite having 1300 active Medicare patients in the clinic. The clinical question asked whether the implementation of an AWV program by nurse practitioners can yield improved compliance with recommended health screenings and vaccinations and diagnosed previously unrecognized clinical conditions. The Iowa model, health belief model and Donebedian's structure-process-outcome model were utilized for the introduction and implementation of the practice change. Evidence was derived from chart review of 50 patients and administration of the SF-36 survey before and following the AWV. Findings and conclusions suggest that the AWV generated improved compliance of preventive services and improved patient quality of life. Addressing preventive health strategies for aging adults is relevant to nursing practice because of the complex and chronic health challenges of this age group. These efforts can reduce the burden of suffering from chronic illness, prevent exacerbation and decline, improve quality of life, and reduce federal and individual health care expenditures to minimize the cost of advanced disease treatment.

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