Date of Award

5-3-2019

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Lynette Rayman

Abstract

As a leading cause of death worldwide, coronary artery disease affects people of all races and ethnicities. The foundation for the prevention of secondary fatal cardiac events, such as stroke or myocardial infarction, is lifestyle modification to effectively lower cholesterol levels. Lifestyle change impacts diet, physical activity, smoking habits, vital sign measures, and stress management. The purpose of this evidence-based practice project was to reduce implement a lifestyle intervention to lower LDL-C levels and promote healthier lifestyles. This practice change was developed utilizing Stetler’s Research Utilization model to promote evidence-based practice changes in the clinical setting. Nola Pender’s Health Promotion model was applied to facilitate the implementation of the intervention. A systematic literature search revealed 16 pieces of evidence that were used to develop a lifestyle modification program which entailed individualized counseling and a patient-guided booklet to facilitate heart healthy lifestyle changes. The created patient-guided booklet contains material from this literature as well as the American Heart Association and the National Institute of Health. A total of 14 adult participants were recruited from a local cardiology practice and were evaluated at their initial evaluation and then again 6 months later. The primary outcome measurement was the low- density lipoprotein cholesterol (LDL-C) drawn from a fasting lipid panel; secondary outcomes measured were blood pressure, body mass index, dietary habits, and physical activity patterns. Paired t-tests were run with a significance level set at p <.05. Significant outcomes that were found include dietary habits (p =.011) and physical activity patterns (p =.031). There was no significant change in LDL-C levels pre- and post- intervention (p =.461). The results of this evidence-based practice project will be used to implement a cost-effective, patient-centered strategy in the clinical setting to lower a patient’s risk for a secondary cardiac event by changing lifestyle choices.

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