Date of Award

Spring 2019

Document Type

DNP Project Restricted

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chairperson

Cheryl Monturo, PhD, MBE, ACNP-BC

Committee Member

Jacquelyn Owens, DNP, CRNP

Abstract

Background & Significance: The Annual Wellness Visit (AWV) is a comprehensive visit to address preventative health needs, including immunization, and breast, colon cancer, and falls risk screenings. The completion of these visits can be difficult for providers during a scheduled office visit. However, implementation of these visits, using a team-based model has been associated with increased numbers of completed AWVs. This quality improvement (QI) project evaluated the effectiveness of a team-based implementation of the Medicare AWV Program in a small, primary care office.

Methods: The electronic health record was reviewed for eligible patients already scheduled for an office visit. Prior to arrival in the office, the patient’s chart was reviewed, and preventive screenings were updated. Upon arrival to the visit, patients were screened using the health risk assessment form.

Results: There were 89 eligible beneficiaries scheduled and a total of 17 AWVs completed over 9 weeks. All patients were screened for falls risk. Most of the patients were up to date for breast and colon cancer screenings, 90% and 72.7% respectively. No immunizations were administered during the AWVs, and 64.7% were up to date for influenza and 47.1% for pneumonia.

Conclusion: AWV completion rates (19%) during the project timeframe for this family practice were consistent with national AWV completion rates (20%) (Beaulieu, 2017). The number of completed AWVs were too small for statistical inference. A QI project is proposed using the Plan-Do-Study-Act framework with the goal of improving completion of AWVs in this family practice office.

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