An Asynchronous Educational Intervention: Knowledge of Appropriateness Criteria for Diagnostic Imaging of Advanced Practice Nursing Students
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PublisherThe University of Arizona.
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AbstractPurpose: The purpose of this quality improvement project (QIP) was to assess and address advanced practice nursing students’ (APNs) knowledge and confidence in ordering diagnostic imaging. This QIP was aimed at providing education on the current diagnostic imaging appropriateness criteria for common presenting complaints, increasing the knowledge and competence of the targeted APNs. This program may guide development of further educational programs to increase competence and knowledge of current and future advanced practice providers (APPs) to prevent overuse and misuse of diagnostic testing, thus improving patient safety and outcomes. Background: There has been an increase in utilization rate of noninvasive diagnostic imaging due to new and readily accessible technologies. Noninvasive diagnostic imaging is often inappropriately or inaccurately ordered by health care providers, thus increasing overall costs, prolonging length of stay, causing treatment delays, and increasing exposure to potentially dangerous radiation, all of which equate to a decreased quality of patient care. Evidence of the magnitude of the problem is the 2017 Medicare mandate requiring use of computerized clinical decision support systems when ordering diagnostic imaging in an effort to decrease diagnostic imaging overutilization. There is limited research to assessing the knowledge and educational preparedness of nurse practitioners when it comes to the ordering and interpretation of radiological imaging. What has been reported is that radiological imaging indications should be incorporated into APPs educational preparation. Education focused on appropriateness criteria for accurately ordering radiological diagnostic tests may lead to improved competence and knowledge of future APPs. Competency in provider diagnostic ordering and criteria education will help reduce both length of stay and radiation exposure, thus promoting better outcomes using cost-effective methods. Framework and Methods: The ACE Star Model of Knowledge Transformation framework was utilized to inform this QIP, beginning with synthesis of evidence-based practice guidelines to create the educational session. The content included a synthesis of diagnostic imaging guidelines presented in case scenarios format delivered by the DNP student project investigator who has practiced as an ACNP for three years. A convenience sample of APNs was recruited from the University of Arizona during their Clinical Skills Intensive workshop. A paper pretest survey was completed by the APNs prior to participation in the educational session addressing identified knowledge gaps of diagnostic imaging and use of The American College of Radiology Appropriateness Criteria, ARC-AC. Following the educational session, which was recorded to provide future asynchronous education, the APNs complete a brief post-survey to assess effectiveness. Assessment of Findings: Following IRB approval, data was collected in spring of 2020. The educational session effectiveness data was analyzed with Excel and a summary of the descriptive statistics was presented to program coordinators of each advance practice specialty to evaluate the session for possible future incorporation into didactic content. Increased awareness and utilization of appropriateness criteria when ordering diagnostic radiological testing may greatly positively impact practice. Armed with knowledge and awareness, these future providers may translate evidence-based guidelines into competency and safe ordering practices, while also decreasing patient costs, radiation exposure and length of stays.
Degree ProgramGraduate College