Family Practice Nursing
Despite being a GOLD guideline and having documented benefits, confirming a COPD diagnosis with spirometry is not routinely done. The purpose of this project was to increase patient referrals for spirometry to confirm COPD diagnosis. A quasi-experimental design was incorporated in a primary care office. A retrospective pre-intervention chart audit and two post-chart audits, 30-days apart, compared the frequency of documented spirometry to confirm a COPD diagnosis. An educational intervention with a pre and post-survey examined provider behavior intention to order spirometry to confirm a COPD diagnosis. The pre-chart audit revealed that 27/50 (54%) of patients had spirometry documented to confirm a COPD diagnosis. Thirty-day post chart audit and feedback intervention revealed 33/50 (66%) and sixty-day post chart audit and feedback intervention revealed 31/50 (62%) of patients had spirometry documented to confirm a COPD diagnosis. The Z-test at 30 days revealed the P-value corresponding to z-1.225 is 0.112. The Z-test from the pre-chart audit to the 60-day post-chart audit revealed the P-value corresponding to z-0.8104 is 0.2088. The post-survey of 6 providers revealed a behavior intention increase from 63.4% to 86.6%, a 23.3% increase in behavior intention. Although there was not a statistically significant increase in the number of spirometry referrals, there was a clinically significant increase. After implementing a chart audit and educational intervention, the provider’s behavior intention also increased. Hence, a chart audit and educational intervention may be helpful to improve primary care provider’s behavior intention for specific clinical practice guidelines.
Demetros, Ruth, "Chart Audit and Educational Provider Feedback Intervention to Improve Appropriate Use of Spirometry in Patients with Chronic Obstructive Pulmonary Disease" (2018). Graduate Student Projects and Scholarship. 22.