Implementing obesity management in primary care: Linking evidence based guidelines with a nurse practitioner model of care

2.50
Hdl Handle:
http://hdl.handle.net/10755/611692
Category:
Full-text
Format:
Text-based Document
Type:
DNP Capstone Project
Level of Evidence:
Other
Research Approach:
Translational Research/Evidence-based Practice
Title:
Implementing obesity management in primary care: Linking evidence based guidelines with a nurse practitioner model of care
Author(s):
Cogswell, Lisa; O'Connor, Nancy A.; Burgermeister, Diane; Hasenau, Susan M.
Additional Author Information:
Lisa Cogswell, DNP, CNP-BC; email: cogswellrn at yahoo dot com
Advisors:
O'Connor, Nancy A.
Degree:
DNP
Degree Year:
2016
Grantor:
Madonna University
Abstract:

Background: Obesity is a rising epidemic, affecting over one third of U.S. adults and over 13% of the world’s population, carrying significant morbidity and mortality. There have been decreasing rates of obesity counseling documented in primary care despite readily available practice guidelines.  Multiple barriers to implementing weight loss counseling into primary care exist including patient and provider lack of motivation, knowledge deficit, and inadequate resources. 

Aims: To utilize a nurse practitioner as the bridge linking evidence to practice for obesity management in primary care.

Methods: Evidence based practice was implemented in a cohort design, in a small, U.S. suburban, primary care practice over four months.  The program included calculating caloric needs, instruction in calorie and exercise tracking, negotiated weight loss goals, weekly home weights, and office follow up every three weeks for weight checks and plan management.

Results: Of the patients who completed the program compliance with follow up was 96%, food and exercise diaries were used 95% of the time, BMI decreased from 35.5%-32.7% and average weight loss was 17.4 lbs.  Comorbidities of hypertension, LDL cholesterol, and fasting blood sugar were improved.

Linking Evidence to Action: Guideline implementation fits within a typical provider schedule, and dedicated visits allow time for focused discussion on weight management.  Initially, patients were given very basic goals – record calories and exercise, then gradually worked on improving healthy behaviors and food choices.  Smart phone apps were the preferred method for calorie tracking.  Creating a culture of partnership and accountability, shared decision making, and patient empowerment was done via use of a nurse practitioner.

Implication for Practice: Partnering with a nurse practitioner can bridge evidence to practice and provide an ideal model of care for a primary care weight loss intervention.

Keywords:
nurse practitioner; obesity; Primary Care; evidence based practice; weight loss
MeSH:
Obesity--therapy; Primary Health Care; Evidence-Based Practice
CINAHL Headings:
Nurse Practitioners; Weight Loss
Note:
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
Repository Posting Date:
2016-06-03T15:10:48Z
Date of Publication:
2016-06-03

Full metadata record

DC FieldValue Language
dc.contributor.advisorO'Connor, Nancy A.en
dc.contributor.authorCogswell, Lisaen
dc.contributor.authorO'Connor, Nancy A.en
dc.contributor.authorBurgermeister, Dianeen
dc.contributor.authorHasenau, Susan M.en
dc.date.accessioned2016-06-03T15:10:48Z-
dc.date.available2016-06-03T15:10:48Z-
dc.date.issued2016-06-03-
dc.identifier.urihttp://hdl.handle.net/10755/611692-
dc.description.abstract<p><strong>Background:</strong> Obesity is a rising epidemic, affecting over one third of U.S. adults and over 13% of the world’s population, carrying significant morbidity and mortality. There have been decreasing rates of obesity counseling documented in primary care despite readily available practice guidelines.  Multiple barriers to implementing weight loss counseling into primary care exist including patient and provider lack of motivation, knowledge deficit, and inadequate resources.  <p><strong>Aims:</strong> To utilize a nurse practitioner as the bridge linking evidence to practice for obesity management in primary care.</p> <p><strong>Methods:</strong> Evidence based practice was implemented in a cohort design, in a small, U.S. suburban, primary care practice over four months.  The program included calculating caloric needs, instruction in calorie and exercise tracking, negotiated weight loss goals, weekly home weights, and office follow up every three weeks for weight checks and plan management.</p> <p><strong>Results:</strong> Of the patients who completed the program compliance with follow up was 96%, food and exercise diaries were used 95% of the time, BMI decreased from 35.5%-32.7% and average weight loss was 17.4 lbs.  Comorbidities of hypertension, LDL cholesterol, and fasting blood sugar were improved. </p> <p><strong>Linking Evidence to Action:</strong> Guideline implementation fits within a typical provider schedule, and dedicated visits allow time for focused discussion on weight management.  Initially, patients were given very basic goals – record calories and exercise, then gradually worked on improving healthy behaviors and food choices.  Smart phone apps were the preferred method for calorie tracking.  Creating a culture of partnership and accountability, shared decision making, and patient empowerment was done via use of a nurse practitioner.</p> <p><strong>Implication for Practice:</strong> Partnering with a nurse practitioner can bridge evidence to practice and provide an ideal model of care for a primary care weight loss intervention.</p>en
dc.formatText-based Documenten
dc.language.isoen_USen
dc.subjectnurse practitioneren
dc.subjectobesityen
dc.subjectPrimary Careen
dc.subjectevidence based practiceen
dc.subjectweight lossen
dc.subject.meshObesity--therapyen
dc.subject.meshPrimary Health Careen
dc.subject.meshEvidence-Based Practiceen
dc.titleImplementing obesity management in primary care: Linking evidence based guidelines with a nurse practitioner model of careen_US
dc.typeDNP Capstone Projecten
thesis.degree.grantorMadonna Universityen
thesis.degree.levelDNPen
dc.description.noteThis work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.en
dc.primary-author.detailsLisa Cogswell, DNP, CNP-BC; email: cogswellrn at yahoo dot comen
thesis.degree.year2016en
dc.type.categoryFull-texten
dc.evidence.levelOtheren
dc.research.approachTranslational Research/Evidence-based Practiceen
dc.subject.cinahlNurse Practitionersen
dc.subject.cinahlWeight Lossen
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