A collaborative project led by a Vanderbilt University School of Nursing researcher and Vanderbilt University Medical Center’s Associate Nursing Officer for Advanced Practice has received funding from the Fellows of the American Association of Nurse Practitioners (FAANP) to roll out a national pilot project aimed at demonstrating the influence of nurse practitioners in reducing unnecessary testing.
VUSN Visiting Professor Ruth Kleinpell, Ph.D., R.N., ACNP-BC, FAANP, FAAN, and April Kapu, DNP, APRN, ACNP-BC, FAANP, will use the FAANP Fellows grant to recruit participants and conduct an expanded Advanced Practice Registered Nurses (APRN) Choosing Wisely collaborative study. The study proposes to replicate a 12-month pilot program led and conducted by APRNs at VUMC that highlighted how they can propose and implement clinical practice changes. In the VUMC study, APRNs focused on determining, and reducing where appropriate, the overuse of lab testing and chest x-rays.
The VUMC program drew inspiration from the American Board of Internal Medicine Foundation’s Choosing Wisely campaign, a national initiative to get health care providers to identify commonly overused tests, procedures and treatments (such as lab tests, use of antibiotics) and consider their necessity on a case-by-case basis. The APRN Choosing Wisely initiative replicated the work of VUMC’s Choosing Wisely steering committee, which had previously spearheaded a successful house staff-led intervention. That project used education and data feedback with goal setting and peer comparison to create safe, significant reductions in daily laboratory testing rates.
In the planned national collaborative, APRNs or APRN teams will identify a Choosing Wisely improvement recommendation for their practices. Vanderbilt teams will coach them over an eight-month period, during which the participants will collect, analyze and compare data; evaluate the resulting quality of care and cost of care changes; and disseminate outcomes through presentations and publications.
APRNs or organizations interested in participating should visit the APRN Choosing Wisely Collaborative study website.