College of Nursing
Problem Statement: Chronic pain patients with widespread musculoskeletal pain are not adequately screened for possible vitamin D deficiency by healthcare providers. Purpose: This quality improvement project (Q.I.) aimed to improve the screening rates for vitamin D among healthcare providers by implementing a clinical reminder tool within the documentation section of the electronic medical records (EMRs) in an outpatient federally funded pain clinic located in the Southeastern region of South Carolina. Methods: A clinical reminder template was embedded within the EMR documentation to increase screening for vitamin D levels for chronic pain patients among healthcare providers. Data were collected six weeks pre-implementation, from early summer of 2022, and six weeks post-implementation, from mid to late summer of 2022, to evaluate the use of the clinical reminder template. Analysis: The mean number of vitamin D screenings completed by healthcare providers before and after the implementation of the clinical reminder template were compared using a Chi-square test. The mean number of serum vitamin D ordered by healthcare providers were compared by using a Fisher Exact test. A parametric t-test and Wilcoxon test were used to compare age, gender, and race. Results: The twelve-week Q.I. project showed improvement in screening for vitamin D deficiency among all healthcare providers. Overall, there was a seventy-nine percent increase in screening for vitamin D deficiency post-implementation of the clinical reminder template among all healthcare providers; physician screening increased from seven percent to seventy-five percent and nurse practitioners increased from eight percent to eighty-one percent. Moreover, serum vitamin D levels ordered were also increased to sixty-two percent post-implementation compared to two percent serum vitamin D levels ordered pre-implementation. Implications for Practice: Implementing a clinical reminder template within the EMR for all pain patients could support a provider’s clinical decision on vitamin D screening by prompting appropriate laboratory testing and vitamin D supplementation as indicated.
Roy, Mercy, "Using a Clinical Reminder Tool to Impact Vitamin D Screening" (2022). Doctor of Nursing Practice Scholarly Projects. 30.