Publication Date

2018

Document Type

Scholarly Project

Disciplines

Family Practice Nursing

Abstract

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.

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