Graduation Year


Degree Type

Open Access Capstone

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Fontaine Sands

Department Affiliation


Second Advisor

Angela Wood

Department Affiliation



One of the leading concerns in the United States healthcare system is the aging population and age-related health concerns such as osteoporosis. Estimates suggest that 50 percent of women and 20 percent of men over 50 are at increased risk of fractures from osteoporosis. However, the diagnosis and treatment of osteoporosis are on a downward trend. If no changes are made by 2040, it is estimated that there will be an annual expense of $95 billion and over 3.2 million fractures per year in the United States alone. The National Osteoporosis Foundation (NOF), along with Healthy People 2030, recommends goals to increase awareness of and screening for osteoporosis to reduce fractures. These recommendations were placed together in this project by using evidence-based techniques from Fracture Liaison Service’s (FLS), Lewin’s Model for Planned Change, and the IHI PSDA Cycle to guide the implementation of this project. This DNP project focused on making a practice change in the primary care clinic by implanting a Bone Mineral Density (BMD) testing algorithm using evidence-based screening and guidelines from the USPSTF and NOF. The project covered four providers for six weeks at a Federally Qualified Healthcare Clinic. There were 424 cases reviewed and it showed a significant increase in osteoporosis screening by implementing the BMD testing algorithm. Furthermore, paired T-tests showed a significant increase in the participants understanding and confidence in ordering BMD tests per guidelines. Although this project had a low number of participants it has the potential to be a base study for further osteoporosis improvement projects and technique implementation in the future.

Included in

Nursing Commons