Date of Award
Evidence-Based Project Report
Doctor of Nursing Practice (DNP)
Kristen L. Mauk
Cardiovascular disease (CVD) has long been recognized as a significant health problem in the U.S., and is the leading cause of preventable death in women, collectively causing about one death per minute (Caboral, 2013). A myriad of modifiable risk factors including dyslipidemia, hypertension, smoking, obesity, and type II diabetes are associated with 80-90% of CVD morbidity and mortality. Despite sobering statistics, valid risk prediction screening tools, and national preventive guidelines, adequate screening in clinical practice settings is sadly deficient. An evidence-based practice project was designed and implemented at a large OB/GYN practice in southern Ohio to address this identified gap in clinical practice. Pender’s health promotion model and Stetler’s evidence-based practice model provided the theoretical foundation for the project. A critical appraisal of current evidence was executed to identify best practice recommendations. The literature was salient in articulating that CVD risk assessment in asymptomatic women was imperative to guide primary prevention interventions, improves patient outcomes, and reduce the economic burden of CVD. Synthesis of the literature supported the use of the Framingham risk score (FRS) model as a gold standard recommendation in the clinical practice setting. The FRS model was applied to a convenience sample of asymptomatic women between the ages of 35-50 who presented for their annual gynecologic exam. Statistical analysis using the SPSS 20 statistical software of the gleaned metrics demonstrated 91% of the project participants with at least one modifiable CVD risk factor. 50.5% (n=55) of the EBP project participants had significant CVD risk factors that necessitated a timely follow up appointment. Using Pearson’s r there were 27 statistically significant relational correlations discerned from the data analysis. The findings garnered from the EBP project were commensurate with the findings reported in the scientific literature. The data analysis provided compelling evidence to support the need for CVD risk screening in asymptomatic women. The literature is salient in xi elucidating anywhere from 25-46% of women consider their gynecologist as their PCP, therefore, the OB/GYN practice setting is a paramount clinical site for implementation of CVD risk screening.
Nelson-Murphy, Kathryn, "Screening Asymptomatic Women for Cardiovascular Risk" (2014). Evidence-Based Practice Project Reports. 54.