Harvey, Kathi

Low back pain (LBP) can be debilitating and result in decreased mobility and reduced quality of life. This paper describes a quality improvement project focusing on managing LBP using an evidenced-based, multimodal approach. The multimodal approach included physical therapy combined with an analgesic and/or anti-inflammatory medication for pain that provide different mechanisms of action. The selected population were patients who presented with low back pain in a primary care setting. The participants attended physical therapy for four weeks while taking an individualized, prescribed medication regimen based on pain rating scores and LBP physical assessment. On the follow-up evaluation, all participants reported reduced pain and 67% demonstrated a decrease of three or more points on the Wong FACES Pain Rating Scale, an increase of five or more points on the Quality of Life Scale, and an increase of five or more points on the Back Pain Function Scale from pre to post intervention. The primary goal of this quality improvement project was to implement and evaluate an evidence-based, multimodal treatment approach to improve health outcomes for persons experiencing LBP. Multimodal LBP management lead to decreased pain, increased mobility, and an increase in the overall quality of life for patients.

The purpose of this Doctor of Nursing Practice (DNP), quality improvement project was to assist participants in the management of their type 2 diabetes through the use an evidencebased Whole-Food, Plant-Based (WFPB) diet approach. The project described the effectiveness of individual WFPB instruction and counseling. Following recruitment, the participant attended weekly dietary counseling sessions focused on incorporating a WFPB diet over a 6-week period. The participant completed the 16-item food intake questionnaire (16-FIQ) pre- and post-dietary counseling along with HgbA1c measurements during the project period. Post dietary counseling resulted in an increase in the participant’s HgbA1c from 8.1% to 8.9%, but the participants showed significant health behavior change as measured in the pre- and post-intervention 16 FIQ. The participant chose less animal-based products and substituted plant-based food choices post dietary counseling. Even though the participant’s HgbA1c showed no improvement, the participant demonstrated increase awareness regarding daily dietary decisions resulting in an increase in plant-based food consumption. Knowledge gained will be used to improve treatment recommendations for persons receiving care for type 2 diabetes at a volunteer primary care clinic in Southeast Florida.