Date of Doctor of Nursing Practice Project Completion
Spring 2025
Faculty Advisor
Dr. Lisa Thomas
Abstract
PURPOSE: This quality improvement project’s purpose was to identify those at risk for low bone density from a clinic’s population of positive fall risk screenings, to encourage bone density screening and identify those who would benefit from bone health optimization.
BACKGROUND: Spine fractures result in serious morbidity and mortality. The type of treatment options available for spine fractures and the timing of intervention is affected by the patient’s bone density.
METHODOLOGY: The aim was for patients diagnosed with spine fractures and degenerative spine conditions to be screened for osteoporosis/osteopenia according to screening recommendation standards. The goals were to maintain a minimum 90% fall risk screening rate, increase bone density screening rate by 20%, and add an electronic health record (EHR) check for bone density screening. Using the DMAIC framework, implementation of technology controls created a hard stop in the EHR for electronic screening for bone density documentation. Enhanced provider communication provided a fall risk warning on the encounter signing screen with an alert to address the positive fall risk screening and a best practice advisory to address the missing bone density with DEXA order.
RESULTS: The fall risk screening rate was maintained at 95% mean during the intervention. The bone density screening rate was increased by 117% from a mean of 12 prior to the interventions to a mean of 26 during the interventions.
IMPLICATIONS FOR PRACTICE: Improved bone density screening rates can guide treatment for those who would benefit from bone health optimization.
Keywords
bone density screening, fall risk, spine fracture
Recommended Citation
Winnegan, Lona, "Improving Bone Density Screening Rates in Patients at Risk for Falls Using Chart Screening and Protocol Orders" (2025). Doctor of Nursing Practice Final Project Abstract. 34.
https://digitalcommons.library.tmc.edu/dnp_abstract/34
