| dc.description.abstract | Overweight and obesity negatively affect multiple acute and chronic disease conditions (USDHHS & ODPHP, n.d.). Two of the most valid and reliable measurements of overweight and obesity are body mass index (BMI) and waist circumference (WC) (NHLBI, n.d.). Despite evidence that waist circumference measurement (WCM) can aid in stratifying risk, the predominant measurement of obesity is BMI alone (Ross et al., 2020).
The purpose of the practice improvement project involved creating a workflow to measure adult WC at wellness visits, increase the frequency of adult WCM, and documentation of WCM in the electronic health record (EHR). The project included increasing provider and nursing awareness and knowledge about the morbidity-associated risks of an elevated WCM through an educational session. Questions posed to participants during post-education debriefing, and post-implementation elicited feedback on the effectiveness of the educational session, anticipated and encountered barriers to WCM, anticipated patient response to WCM, encountered benefits, and perceived sustainability of WCM. Patients also received information about the health risks associated with an elevated WCM through readily accessible educational materials.
Data collected during the project included the number of patients allowing a WCM, patients refusing WCM, educational pamphlets given to patients, WCM documented in the EHR, and number of WCM discussed between patient and provider during the clinic visit. Participant responses to debriefing questions suggested the educational session effectively increased knowledge and awareness of the morbidity-associated risk of an elevated WCM. Post-implementation question responses identified challenges with nurse staffing and documentation of WCM in the EHR as the most commonly encountered barriers. The most common benefit was that a WCM allowed an entry point for a conversation between patient and provider about health problems associated with increased central obesity. Patients allowing a WCM equaled 125, with only three patients refusing. Ninety-five percent of patients had a WCM documented in the EHR, 83% had the WCM discussed during the clinic visit, and 76% had the WCM documented in the providers’ clinic notes. Over half of patients received an educational pamphlet on WC during the project. Since the project was successful, recommendations included continuing WCM at primary care wellness visits. | en_US |
