create a draft discussion

Administration: Yes ___ No_X__

Clinical: Yes _X__ No___

Educational administration: Yes ___ No _X_

Informatics: Yes ___ No _X_

Policy: Yes ___ No _X_

Organization philosophy or mission and vision statement: Miami Wellness Pain Relief Center is committed to delivering a high level of patient-focused pain management within a variety of sites in Miami-Dade and Broward counties(Miami Wellness-Pain Relief Center, 2025). Its mission is to reduce discomfort, restore functioning, and improve the quality of life, which is achieved by providing personalized, evidence-based care, board-certified specialists trained in anesthesia, orthopedics, and physical medicine and rehabilitation. The vision of the center is to help patients live healthier and pain-free lives without surgery using the innovative, interprofessional solution of pain relief. The practice site represents a clinical pain management consultation environment, which is a mixture of an interprofessional team of board-certified physicians, nurse practitioners, and physical therapists dedicated to providing an individual approach to chronic and post-surgical pain treatment.

Quality and safety/risk management: Yes _X_ No ____

Significant financial concerns: Yes __X__ No _____

Procedural or process issue: Yes __X__ No ____

Unsatisfactory patient outcomes: Yes __X__ No ______

Different between hospital and community practice: Yes __X___ No _____

Other (define in space below): Yes ____ No __X___

Wide variation in practice: Y es ___X__ No _____

Clinical practice issue: Yes __X__ No _____

The proposed DNP practice change project is directly aligned with the mission of Miami Wellness Pain Relief Center which is to provide high-level, patient-centered pain management that can alleviate pain, restore functions and improve quality of life. In an attempt to enhance functionality and reduce pain without resorting to surgery, Miami Wellness is determined to be at par with the latest guidelines in pain management. This project fulfils that commitment by providing an evidence-based protocol of antineuropathic prescribing to nurse practitioners and physicians, making pregabalin and gabapentin the frontline drug of choice instead of opioids to treat lumbar radiculopathy. This project contributes to the philosophy of comprehensive, innovative, and personalized care practiced by the center. This is achieved through standardization of provider prescribing practices in the interprofessional team of physicians, nurse practitioners, and physical therapists, providing patients with the safest and most effective pharmacological treatment available and engaging in their active rehabilitation path.

The proposed DNP project is also strategically placed to greatly improve the organizational performance of Miami Wellness Pain Relief Center through the direct reduction of the clinical and financial risks involved in the opioid-based prescribing practices among the healthcare professionals. A heavy burden of downstream costs exists in opioid prescribing such as the management of adverse drug events, patient readmissions, dependency treatment referral, and the mounting regulatory burden by state and federal bodies(Oster, 2023; Florence et al., 2020). The center can reduce these risks by applying a structured antineuropathic prescribing tool to nurse practitioners and physicians, and at the same time increase the patient satisfaction scores, which are key performance indicators in value-based care reimbursement strategies. Better compliance in provider prescribing will result in enhanced pain control and functional outcomes, minimize unnecessary follow-up visits, decrease treatment timelines, and allow an improved use of the existing interprofessional team without necessitating a significant capital investment (Gimenez-Campos et al., 2022; Kwon et al., 2024).

Moreover, this project fits the business model of Miami Wellness, which provides high-quality and innovative, non-surgical pain solutions in various locations in Miami-Dade and Broward counties directly. Miami Wellness is dedicated to keeping up with the recent developments in pain management, which will enable patients to experience long-term relief with minimal surgical intervention. The proposed project supports that vision by presenting evidence-based pharmacological guidelines based on the current clinical literature and aimed at prescribing providers in the front line. Uniformity in the prescription of antineuropathic medications across the center's location enhances regulatory compliance, minimizes the exposure to opioid-related liability and places Miami Wellness in a good position to be reviewed during accreditation. This is a cost-efficient and scalable provider-centered intervention that enhances the center’s competitive status in the South Florida pain management market and within the context of the main mission of the center to empower patients to live healthy and pain-free lives.

Family: Yes ___ No _X__

Individual: Yes _X__ No ___

Institution/system: Yes _X__ No ___

Population: Yes _X__ No ___

Other (define in space below): No

Quantitative (PICOT)

Population: Nurse practitioners and physicians at Miami Wellness Pain Relief Center who manage and treat adults with lumbar radiculopathy in the interprofessional pain management consultation setting.

Intervention: The proposed intervention is the introduction of an evidence-based, structured antineuropathic prescribing protocol to target nurse practitioners and physicians, whereby pregabalin or gabapentin is the initial pharmacological intervention in the management of lumbar radiculopathy, administered under physician or nurse practitioner supervision in Miami Wellness Pain Relief Center.

Comparison: The present provider practice of opioid-based pharmacological treatment as the main method of managing pain in adults with lumbar radiculopathy, which is accompanied by high risks of patient dependency, adverse side effects, sedation, and decreased patient involvement in physical therapy and rehabilitative care.

Outcome: A significant change in patient pain intensity scores, using the Visual Analog Scale (VAS) and improved functional outcomes, using the Oswestry Disability Index (ODI), and an increase in provider adherence to antineuropathic prescribing guidelines and patient involvement in physical therapy rehabilitation.

Timeframe: Eight (8) weeks after the start of the antineuropathic prescribing protocol, which will give enough time to assess the compliance of the providers in prescribing, pain reduction, and functional improvement in the patients and adherence in the clinical setting.

Integrative Literature review: Yes __X__ No ___

Guidelines: Yes _X__ No ___

Clinical Expertise: Yes _X__ No ___

Systematic Literature review: Yes __X__ No ____

Expert opinion: Yes __X__ No ____

Financial analysis: Yes _X__ No ___

Standards (regulatory, professional, community): Yes _X__ No ___

Patient preferences: Yes __X_ No ___

Other (define in space below): Yes _X__ No ___

For nurse practitioners and physicians managing adults with lumbar radiculopathy (P), does the use of antineuropathics like pregabalin or gabapentin as the first treatment (I) instead of opioids (C) help reduce pain and improve their ability to function more (O) over eight weeks (T)?