Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Diane Whitehead

Abstract

One out of 2 women and 1 out of 5 men over age 50 will sustain a fragility fracture (FF) in their lifetime. The risk of a 2nd FF increases dramatically after the 1st fracture and can lead to pain, disability, and mortality. Despite the evidence that secondary prevention programs are effective, the local facility did not have a formal mechanism to address this need. The purpose of this project was to design a program for secondary prevention of FFs and to address the need for a program for secondary FF prevention that was sustainable locally. The program was designed for facility patients age 50 or older who sustained a wrist fragility fracture within 6 months. The reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework was used to guide the project and program evaluation. A needs assessment was conducted prior to developing the program and included secondary data from the facility's provider survey. The 'Own the Bone' program, a nationally recognized program, was chosen as the intervention model. The 'Own the Bone' program provided a registry data for performance measures which assisted in the development of the program. The program included a short survey for providers to assess satisfaction with the referral process, and a telephone survey to referred patients who chose not to attend. Patient satisfaction with the program incorporated the Standardized Clinician Group Consumer Assessment of Healthcare Providers and Systems survey. Data collection and analysis plans were provided to the site with recommendations for implementation. This program was the 1st step in closing the local research-practice gap of secondary fragility fracture prevention. The project offers an opportunity to promote positive social change through the prevention of FF in a setting that had not previously addressed the problem.

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