Date of Award

Spring 5-28-2022

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Pedro Colio, DNP, RN, FNP-C, ENP-C, CCRN

Abstract

Background/Purpose: Iron deficiency anemia (IDA) is the most common micronutrient deficiency globally. More than 20% of women experience IDA during the reproductive year. As the first-line treatment in IDA, oral iron supplement (IOS) is associated with gastrointestinal side (GI) effects, and it is often a barrier to achieving normal hemoglobin (Hb) and serum ferritin (SF) levels. Ineffective treatment fueled by a lack of guidelines increases the dilemma of dosing frequency in primary care, leads to poor quality of life, and increases the burden of anemia.

Intervention: Evidence showed that intermittent OIS is as effective as daily dosing. It is associated with fewer GI side effects, increased Hb and SF, and compliance.

Methods: The San Diego (SD) 8A's Evidence-Based Practice (EBP) Model guided this practice change. Research articles were reviewed for evidence. The project evaluated the application of EBP guidelines among the primary care providers (PCPs), identified patients diagnosed with IDA with a Hb/dl and SF < 20 ng/mL who are currently on daily OIS dosing and educated PCP for practice change to alter the dosing frequency to every other day. Levels of Hb, SF, and GI side effects at pre-and post-intervention were evaluated to assess practice change.

Results: Providers' survey revealed the lack of consensus in applying EBP guidelines. Comparison of data shows the mean of Hb and SF were significantly different between pre-and post-data with p = .001 for Hb and p = .003 for SF. The results indicate that a change to every other day dosing effectively increased levels of Hb and SF and decreased GI side effects.

Implication for Nursing: Clinicians should adopt the practice with positive patient outcomes. The results will guide clinicians to select every other day OIS as a preferred form of treatment of IDA, resulting in fewer GI side effects, improved compliance, and effectiveness of anemia reversal.

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