Semester

Spring

Date of Graduation

2013

Document Type

Dissertation

Degree Type

DNP

College

School of Nursing

Department

Not Listed

Committee Chair

Susan McCrone.

Abstract

Thirty million or 52% of males between 40 and 70 years of age in the United States have some degree of erectile dysfunction (ED) (Feldman et al., 1994; Hakim, Subit, Kandzari, & ZasLau, 2002; Tsertsvadze et al., 2009). The American Urology Association (AUA) outlines measures to slow the rate of, control, and treat ED. To decrease the prevalence, ED must be diagnosed, identified, and the major risk factors aggressively controlled. Utilization of clinical practice guidelines (CPGs) may improve identification and documentation of treatment, but questions remain about how to implement CPGs in practice. The purpose of this pilot project was to evaluate the effectiveness of the International Index of Erectile Function (IIEF-5) questionnaire on the diagnosis and treatment of ED in two primary care rural clinics in West Virginia. Through the use of Diffusion of Innovation Theory, the IIEF-5 questionnaire was utilized and implemented into the clinics. This study used a descriptive design with pre and post chart reviews and a convenience sample of 121 male patients 40-70 years old. Clinicians and staff were oriented to the use of a screening instrument before its implementation. The questionnaire was piloted for six-weeks. Data from chart reviews were collected from 50 randomly selected charts pre and 89 charts post implementation. Of the 89 post implementation charts, only 71 were eligible for the pilot project. The pre implementation prevalence was 5/50 (10%) and documentation for treatment of ED pre implementation was 2/5 (40%). Post implementation the prevalence of ED was 53/71 (75%) and documentation of treatment options in those completing the questionnaire was 42/53 (79%). There were no significant differences in ages for males 50 to 70 years between the pre and post implementation group (0.6). However, there was a statistical significant difference between the pre and post implementation males ≤ 49 years of age. In Group 1 -- 21/50 (42 %) of the men were ≤49; Group 2 -- 4/71(5.6%) were ≤ 49 years. Prevalence of ED in Group 1 - participants 50 - 70 years of age was 5/29 (17%), while prevalence of ED in Group 2 - participants 50 - 70 years of age was 50/66 (76%). There was one participant in the group with an unknown age. All 71 (100%) questionnaires were scanned into the patient's charts and a diagnosis of ED was added to the patients list of health care issues. The use of the IIEF-5 questionnaire in primary care clinics is an effective tool for evaluating the diagnosis and treatment of ED and can easily be incorporated into the patients' charts.

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