Document Type
Dissertation
Degree
Doctor of Nursing Practice
Major
Nursing
Date of Defense
6-23-2017
Graduate Advisor
Susan L. Dean-Baar, Ph.D., RN, FAAN
Committee
Susan L. Dean-Baar, Ph.D., RN, FAAN
Nancy Magnuson, DSN, FNP, RN
Gretchen H. Levey, MD, OB/GYN
Abstract
ABSTRACT
Background
Overweight and obesity have significant impact and consequences on women leading to reduced quality of life, comorbid conditions and premature mortality. Many healthcare providers lack adequate training and the time to properly treat overweight and obesity. Algorithms have been shown to improve clinical knowledge and save time.
Objectives
To develop an algorithm for weight loss assessment and treatment to aid in the clinical decision-making process while improving the quality of care for overweight and obese clients in an efficient manner that can be replicated.
Methods
After an extensive literature review to identify best-practice guidelines for weight loss a retrospective chart review was performed at two women’s health clinics located in St. Louis County over a five-month period. For three consecutive appointments 50 patient charts were audited and compared to current evidence-based practice guidelines. Any gaps between the office practice and the guidelines were identified. A weight loss algorithm was then developed incorporating clinical assessment methods, lab work, anthropometric measurements and appropriate referrals.
Results
Fifty patient’s charts spanning from 10/2014-01/2017 were examined and compared to evidence-based clinical guidelines for weight loss. The comparison revealed gaps between evidence based research and practice related to lack of time, not wanting to add additional work for the staff/ healthcare providers, and forgetting to include various assessments and referrals. To improve the assessment practice while saving valuable clinical time, an algorithm was recommended as a template to use in the electronic health records (EHR) along with a hard-copy paper form. Additional measurements were added to the women’s health clinic computer system for neck and waist circumference by their IT staff, and a packet was developed containing assessment questionnaires for patients to either complete prior to coming to the initial appointment or fill out while in the waiting room. This weight loss algorithm was then presented to the participating clinician for implementation for a future pilot study.
Recommended Citation
Tice Williams, Jennifer A., "A Functional Algorithm for Weight Loss and Obesity Practice: Guide for Clinical Decision-Making for Treating Women" (2017). Dissertations. 694.
https://irl.umsl.edu/dissertation/694
Included in
Cardiovascular Diseases Commons, Dietetics and Clinical Nutrition Commons, Digestive System Diseases Commons, Endocrine System Diseases Commons, Endocrinology, Diabetes, and Metabolism Commons, Female Urogenital Diseases and Pregnancy Complications Commons, Geriatric Nursing Commons, Internal Medicine Commons, Medical Nutrition Commons, Nutritional and Metabolic Diseases Commons, Obstetrics and Gynecology Commons, Other Nursing Commons, Preventive Medicine Commons, Primary Care Commons, Reproductive and Urinary Physiology Commons