Date of Conferral

2021

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Maria Ojeda

Abstract

Abstract

In the United States, approximately 10 million adults 50 years and older are plagued by osteoporosis; this number has been projected to climb to 14 million by 2020. Osteoporosis is a debilitating disorder characterized by significant loss of bone mass and mineral density. Without proper screening and diagnosis, patients may not receive the appropriate medical treatments to avoid worsening of their condition and its associated complications. Nurses can help identify patients at risk for osteoporosis by administering osteoporosis screening during routine office visits. The practice-focused question asked whether the Fracture Risk Assessment Tool (FRAX) increased the proportion of bone density testing and decreased the proportion of falls with fractures. The purpose of this doctoral project was to evaluate the effectiveness of quality improvement (QI) project on the proportion of bone density testing and falls with fractures among primary care clinic patients 50 years and older 12 months after implementation. The theoretical framework that guided this doctoral project was the Donabedian model of care. De-identified and aggregated data before and after tool implementation was obtained from the QI department. The use of the FRAX increased the proportion of bone density testing by 58 percentage points (from 13% to 71%) and decreased the proportion of falls with fractures by 4.3 percentage points (from 28.3% to 24%). The project findings were shared with the QI manager within the facility. The implication for nursing practice is that improved screening and initiation of preventive measures can reduce osteoporosis-related fractures. The implication for positive social change is the prevention of early death and disability achieved through early screening, detection, and treatment of osteoporotic symptoms.

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