Date of Award

Spring 5-26-2018

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Joseph Burkard, DNSc, CRNA, AACN

Second Advisor

David Bittleman, MD

Abstract

Background: Various psychosocial factors affect follow up care among veterans with chronic pain. Engaging veterans by giving them the choice to decide contact modality for after clinic visit increases likelihood of successfully reaching patient and adherence to recommended pain management.

Purpose: To engage veterans through self-determined effective communication method: telephone, email or Myhealthevet for follow up care. The intervention aims to improve chronic pain self-care by assessing number of medications used for pain, numeric pain rating and quality of life score.

Framework/EBP Model: The Iowa Model and 5A’s will guide implementation and assessment of this project. Patients will self-determine the best modality for follow up care and the chosen modality will be used to contact patient. Ease of contact will be assessed based on number of attempts made before contact initiated.

Evidenced-based Intervention: Communicating with patients using a modality they prefer increases likelihood of being able to contact patient for follow up care. There is no difference in outcomes when other modalities are used compared to phone calls.

Results/Outcomes: The DNP student was successful at making contact with all the patients with one to two attempts. All the patients rated their pain scores at least one point less on average and quality of life scores improved by two points on average. There was however no change in the number of pain medications used regularly.

Conclusion: Engaging patients by having them choose their preferred method of communication may increase rates of follow up contact among veterans with chronic pain.

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