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由执业护士管理的骨质疏松症疾病管理项目的成果。

Outcomes of an osteoporosis disease-management program managed by nurse practitioners.

作者信息

Greene Denise, Dell Richard M

机构信息

Kaiser Permanente, Orthopedics, 9897 Fonte RD, Cypress, California 90630, USA.

出版信息

J Am Acad Nurse Pract. 2010 Jun;22(6):326-9. doi: 10.1111/j.1745-7599.2010.00515.x.

Abstract

PURPOSE

To detail the outcomes of an osteoporosis disease-management program where nurse practitioners (NPs) have taken a leadership role in screening, diagnosing, and treating patients at risk for osteoporosis.

DATA SOURCES

An electronic medical record (EMR) was used to collect demographic, pharmacy, dual x-ray absorptiometry (DXA) scan, and fracture data from a population of over 625,000 patients with one or more risk factors for osteoporosis. Monthly reports were generated and distributed to the NPs to assist them in identifying patients that required screening or treatment.

CONCLUSIONS

Over a 6-year period there was a 263% increase in the number of screening DXA scans done each year, a 153% increase in the number of patients on anti-osteoporosis medications each year, and a 38.1% decrease in the expected hip fracture rate.

IMPLICATIONS FOR PRACTICE

NPs play an important leadership role in managing osteoporosis within a large health maintenance organization. The screening and interventions used can be applied by any NP in any practice setting on an individual basis to reduce hip fracture rates in the United States.

摘要

目的

详细介绍一项骨质疏松症疾病管理项目的成果,该项目中执业护士(NP)在对骨质疏松症高危患者进行筛查、诊断和治疗方面发挥了领导作用。

数据来源

使用电子病历(EMR)收集了超过62.5万名有一个或多个骨质疏松症风险因素的患者的人口统计学、药学、双能X线吸收测定法(DXA)扫描和骨折数据。每月生成报告并分发给执业护士,以帮助他们识别需要筛查或治疗的患者。

结论

在6年期间,每年进行的筛查DXA扫描数量增加了263%,每年接受抗骨质疏松药物治疗的患者数量增加了153%,预期髋部骨折率下降了38.1%。

对实践的启示

执业护士在大型健康维护组织中管理骨质疏松症方面发挥着重要的领导作用。所采用的筛查和干预措施可由任何执业护士在任何实践环境中单独应用,以降低美国的髋部骨折率。

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