Practice Guidelines for Self-Management of Osteoarthritis Pain in the Home-Based Settings

Practice Guidelines for Self-Management of Osteoarthritis Pain in the Home-Based Settings by Oyesola Akintan MSN, Howard University, 2009 BSN, Bowie University, 2006 Project Proposal Submitted in Partial Fulfillment of the Requirements for the Degree of Doctorate of Nursing Practice Walden University January 2015 Abstract Osteoarthritis (OA) is a debilitating chronic illness that can prevent older adults from accomplishing their activities of daily living or ambulate without pain. The project’s purpose was to develop and disseminate multidisciplinary educational practice guidelines to nurses for use in older homebound male Veteran’s Administration OA patients to improve home-based pain management and self-care preventative strategies. Orem’s theory of self-care managementOsteoarthritis (OA) is a debilitating chronic illness that can prevent older adults from accomplishing their activities of daily living or ambulate without pain. The project’s purpose was to develop and disseminate multidisciplinary educational practice guidelines to nurses for use in older homebound male Veteran’s Administration OA patients to improve home-based pain management and self-care preventative strategies. Orem’s theory of self-care management constituted the theoretical framework. The design was a quality improvement project and involved formation of 6 panels of interdisciplinary teams who reviewed the American Society of Anesthesiologist (ASA) and Osteoarthritis Research Society International (OARSI) guidelines. The ASA and OARSI guideline components were evaluated via a scoring sheet for pain control and self-management effectiveness for the OA patient. The panels assessed these treatment plans in terms of suitability, tolerance, and patient adherence for inclusion into the educational program. The panel members independently reviewed both sets of guidelines and then convened as a group to share their scores and reach a consensus on these guidelines, in the patient population served. Agreement of 85% among the panel members was needed for inclusion into the practice guideline. Based on the scoring results the panel concluded that the ASA and OARSI guidelines would likely improve pain control, functional ability, and psychological well-being essential to lifestyle modifications and OA symptoms management education program. The social impact of developing nursing practice guidelines for the self-management of OA pain in home-based settings will be manifested in better patient lifestyle and behavior modification leading to better symptom management. Practice Guidelines for Self-Management of Osteoarthritis Pain in the Home-Based Settings by Oyesola Akintan MSN, Howard University, 2009 BSN, Bowie University, 2006 Project Proposal Submitted in Partial Fulfillment of the Requirements for the Degree of Doctorate of Nursing Practice Walden University January 2015 Dedication This project is dedicated to my mother (Omolara M. Eniola), my husband (Charles Akintan), and my three loving children (Joyce, Jumoke, and Joshua Akintan). I value my family’s unconditional love and perseverance during my course of studies. My family’s encouragement and support have improved my ability to complete my doctorate. My mother’s consistency and belief in quality education since youth has always reminded me of the worth of continuing my education. This doctorate project is also dedicated to my grandmother (Alhaja Falilat Abdul Azeez) for how well she raised me and believed in my success. The hard work and motivation inculcated to me have assisted me go a long way in life. Further, I believe that without the favor of Almighty God, I will not be where I am today. Acknowledgments I will like to recognize my academic mentors (Dr. Eric Anderson, Dr. Susan Fowler, and Dr. Mercy Popoola) who have greatly impacted and improved my capacity and ability to learn; for believing in me and taking each step with me to complete my doctorate project. I am confident that you believed in me and saw something valuable that was difficult for me to envision during the standstill period of my course work. My gratitude to both of you is beyond reproach. To my clinical preceptors Carolyn Rainey and Terry Mikovich; I am grateful for your relentless support, guidance and mentorship. I appreciated Terry Mikovich’s patience and encouragement during my struggle. Words alone cannot express my gratitude because you are such a great leader. May God continue to grant you what your heart desires!