Implementation of Rheumatoid Arthritis Assessment Tool: A Quality Improvement Project

2.50
Hdl Handle:
http://hdl.handle.net/10755/620879
Category:
Full-text
Format:
Text-based Document
Type:
DNP Capstone Project
Level of Evidence:
Other
Research Approach:
N/A
Title:
Implementation of Rheumatoid Arthritis Assessment Tool: A Quality Improvement Project
Author(s):
Mooroian-Pennington, Christina; Dunn, Dorothy J.
Advisors:
Dunn, Dorothy J.; Reynolds, Mary Anne Hales
Degree:
DNP
Degree Year:
2016
Grantor:
Northern Arizona University
Abstract:

Objective.  Rheumatoid arthritis is a common inflammatory arthritis resulting in joint destruction that leads to physical and functional disability.  This condition is characterized by variable disease activity levels, defined as low, moderate, and high.  The higher the disease activity the more at risk the patient is for joint joint destruction.  The routine use of an approved composite index for disease activity is recommended to assess disease activity level at each office visit.  The American College of Rheumatology approved six composite indices; the Patient Activity Scale (PAS), the Patient Activity Scale II (PAS-II), the Routine Assessment of Patient Index Data 3 measures (RAPID 3), the Clinical Disease Activity Index (CDAI), the Disease Activity Score with 28-joint count (ESR or CRP) (DAS28-ESR or DAS28-CRP), and the Simplified Disease Activity Index (SDAI).  The RAPID 3 was chosen to implement because it is patient-focused, its ease of use, and it does not require formal joint counts or acute phase reactants values to determine disease activity.  Methods.  This quality improvement project resulted in the implementation of the RAPID 3 at a rural rheumatology clinic.  The RAPID 3 composite index was used to assess disease activity levels in patients with rheumatoid arthritis over a seven-week period.  At the end of implementation, the providers were given a questionnaire to evaluate their opinions regarding feasibility, clinical relevance, and satisfaction with using the RAPID 3.  The questionnaire was followed by interviews.  Results.  The results showed that the staff and health care providers found the RAPID 3 to be feasible.  It was easily integrated into the clinic workflow, it was easy to score and interpret given the time constraints of office visits.  The health care providers found the RAPID 3 clinically relevant, meaning that it interpreted disease activity levels accurately.  They also identified the importance of the RAPID 3 and that it should be used on a routine basis.  The providers also identified satisfaction with improved communication with their patients, who were focused and ready for the office visit.

Keywords:
Rheumatoid arthritis; Assessment instruments; RAPID 3
CINAHL Headings:
Arthritis, Rheumatoid; Clinical Assessment Tools; Quality Improvement
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:
2016-10-07T21:03:17Z
Date of Publication:
2016-10-07

Full metadata record

DC FieldValue Language
dc.contributor.advisorDunn, Dorothy J.en
dc.contributor.advisorReynolds, Mary Anne Halesen
dc.contributor.authorMooroian-Pennington, Christinaen
dc.contributor.authorDunn, Dorothy J.en
dc.date.accessioned2016-10-07T21:03:17Z-
dc.date.available2016-10-07T21:03:17Z-
dc.date.issued2016-10-07-
dc.identifier.urihttp://hdl.handle.net/10755/620879-
dc.description.abstract<p><strong>Objective.</strong>  Rheumatoid arthritis is a common inflammatory arthritis resulting in joint destruction that leads to physical and functional disability.  This condition is characterized by variable disease activity levels, defined as low, moderate, and high.  The higher the disease activity the more at risk the patient is for joint joint destruction.  The routine use of an approved composite index for disease activity is recommended to assess disease activity level at each office visit.  The American College of Rheumatology approved six composite indices; the Patient Activity Scale (PAS), the Patient Activity Scale II (PAS-II), the Routine Assessment of Patient Index Data 3 measures (RAPID 3), the Clinical Disease Activity Index (CDAI), the Disease Activity Score with 28-joint count (ESR or CRP) (DAS28-ESR or DAS28-CRP), and the Simplified Disease Activity Index (SDAI).  The RAPID 3 was chosen to implement because it is patient-focused, its ease of use, and it does not require formal joint counts or acute phase reactants values to determine disease activity.  <strong>Methods.</strong>  This quality improvement project resulted in the implementation of the RAPID 3 at a rural rheumatology clinic.  The RAPID 3 composite index was used to assess disease activity levels in patients with rheumatoid arthritis over a seven-week period.  At the end of implementation, the providers were given a questionnaire to evaluate their opinions regarding feasibility, clinical relevance, and satisfaction with using the RAPID 3.  The questionnaire was followed by interviews.  <strong>Results.  </strong>The results showed that the staff and health care providers found the RAPID 3 to be feasible.  It was easily integrated into the clinic workflow, it was easy to score and interpret given the time constraints of office visits.  The health care providers found the RAPID 3 clinically relevant, meaning that it interpreted disease activity levels accurately.  They also identified the importance of the RAPID 3 and that it should be used on a routine basis.  The providers also identified satisfaction with improved communication with their patients, who were focused and ready for the office visit.</p>en
dc.formatText-based Documenten
dc.language.isoenen
dc.subjectRheumatoid arthritisen
dc.subjectAssessment instrumentsen
dc.subjectRAPID 3en
dc.titleImplementation of Rheumatoid Arthritis Assessment Tool: A Quality Improvement Projecten
dc.typeDNP Capstone Projecten
thesis.degree.grantorNorthern Arizona 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.-
thesis.degree.year2016en
dc.type.categoryFull-texten
dc.evidence.levelOtheren
dc.research.approachN/Aen
dc.subject.cinahlArthritis, Rheumatoiden
dc.subject.cinahlClinical Assessment Toolsen
dc.subject.cinahlQuality Improvementen
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