Date of this Version
2024
Document Type
DNP Project
Abstract
Background: Although current clinical practice guidelines recommend first taking patient history, performing a physical examination, limiting imaging use for suspicion of serious pathology, and assessing psychosocial factors, studies show that only a small percentage of low back pain (LBP) patients receive this evidence-based care. Instead, a significant portion of LBP patients undergo unnecessary imaging referrals and are prescribed opioids. This overreliance on imaging increases healthcare costs, exposes patients to potential risks, and may lead to unnecessary interventions and risk for dependence.
Purpose: The aim of this project is to improve healthcare providers' knowledge regarding the management of low back pain by emphasizing traditional history-taking and physical examination techniques (flexion, extension, rotation, side-bending) as a diagnostic screening tool to replace unnecessary plain radiograph, or X-radiation (X-ray), imaging for common spine conditions unless serious pathology is suspected. With evidence-based interventions, providers can confidently shift from imaging dependence to a patient-centered approach.
Methods: The pilot project took place at a medical office, where five participants were voluntarily recruited. Data collection and analysis were focused on pre- and post-intervention tests to determine the effectiveness of the educational program in increasing provider awareness and confidence in managing back pain without relying on x-ray imaging. The test included 8 demographic questions, 12 knowledge questions, and 4 confidence-rating scale questions related to common lumbar spine conditions and management. Participants completed a pre-test, followed by a 15-minute evidence-based educational session demonstrating six lumbar motion assessment techniques (flexion, extension, left/right rotation, and left/right bending), and their significance in patient evaluation. Finally, participants completed a post-test after four weeks.
Conclusion: The intervention led to a notable increase in provider confidence in managing low back pain without x-ray imaging, with a mean improvement of 28%. Although the sample size was small, the results suggest that targeted education on evidence-based guidelines can enhance provider confidence and potentially reduce unnecessary imaging.
Implications for Practice: Improving provider understanding of back pain causes, evidence-based diagnostic methods, and Advanced Practice Nurse leadership can boost provider confidence, interprofessional collaboration, organizational efficiency, and patient care quality while lowering healthcare costs for both the patient and the healthcare system.
Recommended Citation
Tam, Cindy W., "Increasing Provider Knowledge and Confidence in Managing Lumbar Spine Conditions Without the Use of X-ray Imaging: A Pilot Project" (2024). Nicole Wertheim College of Nursing Student Projects. 326.
https://digitalcommons.fiu.edu/cnhs-studentprojects/326