Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-13-2023

Graduate Advisor

Susan Dean-Baar, PhD, RN, CENP, FAAN

Co-Advisor

Jennifer Vines, DNP, MSN, RN

Committee

Troy Dinkel, MD

Abstract

Implementation of a Vestibular Disorder Screening Tool in an Urgent Care

Kathleen A. Probst

M.S.N., University of Missouri-Columbia, 2007

B.S.N., University of Missouri-Columbia, 2004

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice

August 2023

Advisory Committee

Susan Dean-Baar, PhD, RN, CENP, FAAN

Chairperson

Jennifer Vines, DNP, MSN, RN

Troy Dinkel, MD

Copyright, Kathleen A. Probst, 2023

Abstract

Problem: Vestibular disorders disrupt everyday living and can cause reduced quality of life. Guidelines developed to screen for vestibular disorders are not efficient to use in the emergency department and are not utilized by some providers due to lack of confidence and training. Patients who present to the emergency department with vestibular disorder symptoms are often left undiagnosed, therefore leading to lack of referrals for vestibular therapy (VT).

Methods: A vestibular screening tool (VST) was introduced to a convenience sample of providers working in an urgent care setting. This quality improvement project analyzed quantitative descriptive data, both retrospective and prospective, comparing the number of VT referrals in patients with a vestibular disorder diagnosis. This project also compared provider confidence levels to diagnosis and refer patients with vestibular disorders.

Results: Comparison of the number of VT referrals made from the retrospective (n=121, 30.58%) and prospective (n=126, 34.92%) data suggest no significant relationship. There was a significant difference in the mean rank for provider confidence level from before and after the VST was introduced (U=838, z = -1.98, p = 0.047).

Implications for Practice: Introduction of a VST in an urgent care setting can increase provider confidence level in diagnosing patients with a vestibular disorder and referring to VT.

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