NSG8105 - Week 4 Assigment

2

Methods Overview for a Nurse Practitioner Led Non-Opioid Pain Management Project

Lisa Berdinassi

NSG8105 – Capstone in Applied Practice II

South University

Dr. Sandra Jones

January 27, 2026

Methods Section Overview

The purpose of this quality improvement project is to examine whether a nurse practitioner–led education session combined with a structured home exercise program focused on non-opioid pain management can influence pain intensity, functional capacity, and self-management strategies among adults with chronic low back pain in a family practice clinic. For participants who are using opioid medications, changes in self-reported opioid use will also be explored as a secondary outcome.

The methods were developed to reflect a practical and realistic approach that fits within a primary care setting. The project emphasizes patient education, low-intensity home exercise, and planned follow-up activities, while also incorporating safety considerations commonly associated with home exercise programs. Overall, the approach is intended to be feasible for implementation in routine practice and adaptable for use by other clinicians interested in non-opioid pain management strategies.

Approach and Design

This project will use a pre- and post-intervention quality improvement design. This approach allows for observation of changes in participant outcomes before the intervention and again after completion of the six-week education and home exercise program. Quality improvement methods are appropriate in clinical practice settings where the focus is on improving care delivery and patient-centered outcomes, rather than testing hypotheses under controlled research conditions.

A single-group design will be used, with participants serving as their own comparison over time. Primary outcomes include changes in pain intensity and functional capacity. When applicable, self-reported opioid use will be reviewed as a secondary outcome. Evidence supports the use of structured non-opioid education and self-management strategies in primary care to improve functional outcomes for individuals with chronic low back pain and to reduce unnecessary reliance on opioid medications (Qaseem et al., 2023; Traeger et al., 2022).

Overall, this design supports evaluation of both feasibility and potential impact of integrating a nurse practitioner–led, non-opioid pain management approach into routine primary care practice.

Site, Agency, and Participant Information

This project will take place in a family practice clinic that provides ongoing primary care services to adult patients with chronic musculoskeletal conditions. Primary care is often the first and most consistent point of contact for individuals with chronic low back pain, making it an appropriate setting for introducing education and non-opioid self-management strategies.

Participants will include adults 18 years of age and older with chronic low back pain who receive care at the clinic. Current opioid use is not required for participation; however, when applicable, self-reported opioid use will be examined as a secondary outcome. Eligible participants must be able to attend an initial education session and obtain medical clearance from their healthcare provider confirming that participation in light physical activity is appropriate.

Individuals with acute low back injuries, significant neurological impairments, or medical conditions requiring specialized or intensive management will be excluded to support participant safety and promote consistency across the sample. This population is well suited for the proposed intervention, as existing evidence supports the effectiveness of nurse practitioner–led education and non-opioid approaches for managing chronic low back pain within primary care settings (Oliphant et al., 2022).

Methods and Proposed Process

This project will begin with a baseline assessment, followed by a nurse practitioner–led education session and participation in a structured home exercise program over a six-week period. A follow-up assessment will be completed at the end of the intervention. Baseline data will be collected prior to the education session, and post-intervention data collection will occur after the six-week program is completed.

Participants will attend a small-group education session led by the Principal Investigator. The session will focus on chronic low back pain, non-opioid pain management strategies, and general instruction for a low-intensity home-based strengthening and stretching routine. Educational content will be guided by current clinical recommendations for the non-pharmacologic management of chronic low back pain.

After the education session and once medical clearance has been obtained, participants will be encouraged to complete the home exercise program approximately three to five days per week, based on individual tolerance. Brief weekly research check-ins will be conducted by telephone or secure messaging to gather self-reported information related to exercise participation and overall experience. These check-ins are intended for data collection purposes only and do not include clinical assessment or changes to medical treatment.

At the end of the six-week period, participants will complete the same outcome measures used at baseline to assess changes in pain intensity, functional capacity, and, when applicable, self-reported opioid use. This step-by-step timeline was selected to ensure feasibility within a primary care setting while maintaining consistency across participants.

Data Collection Tools and Anticipated Use

For the formal data collection plan that will be expanded in Week 7, several standardized instruments are planned for use in this project. Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), a tool commonly used in clinical settings that has demonstrated validity and sensitivity among adults with chronic low back pain. Functional capacity will be assessed using the Oswestry Disability Index (ODI) Version 2.1a, which is widely recognized for its reliability across musculoskeletal populations.

When applicable, opioid use will be examined as a secondary outcome and will be measured through participant self-report using a brief opioid use tracking form. No electronic medical record access, chart review, or prescription refill data will be used at any point in this project. The selected instruments are appropriate for quality improvement initiatives and are supported in the literature as reliable methods for evaluating pain and functional outcomes in clinical practice (Hicks et al., 2021).

Taken together, this overview provides the foundation for a comprehensive Methods section that will be further refined in subsequent course assignments. The overall structure reflects a practical, evidence-informed approach that is feasible for implementation during NSG8110.

References

Hicks, G. E., Stump, T. K., & Horn, M. E. (2021). Measuring outcomes in chronic low back pain. Journal of Orthopaedic and Sports Physical Therapy, 51(3), 123–125. https://doi.org/10.2519/jospt.2021.10520

Oliphant, D., Fee, C., & Kaye, A. D. (2022). Non opioid strategies for managing chronic low back pain in primary care. Pain and Therapy, 11(2), 343–358. https://doi.org/10.1007/s40122

Qaseem, A., Wilt, T. J., & McLean, R. M. (2023). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical guideline update. Annals of Internal Medicine, 176(4), 558–569. https://doi.org/10.7326/M22

Traeger, A. C., Buchbinder, R., & Maher, C. G. (2022). Advancing the management of low back pain. BMJ, 376, e068218. https://doi.org/10.1136/bmj