Ensuring vitamin D supplementation in nursing home patients--a quality improvement project.

Journal Article (Journal Article)

Randomized controlled trials have shown that adequate vitamin D supplementation in nursing home (NH) residents reduces the rates of falls and fractures. In our NH, review of medication administration records of all patients (n = 101) revealed that only 34.6% of the patients were currently prescribed adequate doses of vitamin D, revealing a need for intervention. We designed a Quality Improvement (QI) project with the objective of improving the vitamin D prescription rate in our NH. We used the Plan-Do-Study-Act (PDSA) approach to implement this QI project. Patients not currently prescribed an adequate dose of vitamin D were identified and started on a daily dose of 800 IU of vitamin D. Additionally, patients who were experiencing falls while on an adequate dose of vitamin D for 3 months were examined for the possibility of vitamin D deficiency and were started on 50,000 IU of vitamin D per week for 12 weeks if they were found to be vitamin D-deficient based on blood levels of 25-hydroxy-vitamin D below 30 ng/mL. We found that with several PDSA cycles over a period of 5 months, the prescription rate for vitamin D was increased to 86%, surpassing our initial goal of 80%. In conclusion, we found that a multidisciplinary QI program utilizing multiple PDSA cycles was effective in reaching target prescription rates for vitamin D supplementation in a population of NH patients.

Full Text

Duke Authors

Cited Authors

  • Yanamadala, M; Heflin, MT; White, HK; Buhr, GT

Published Date

  • 2012

Published In

Volume / Issue

  • 31 / 2

Start / End Page

  • 158 - 171

PubMed ID

  • 22607104

Electronic International Standard Serial Number (EISSN)

  • 2155-1200

Digital Object Identifier (DOI)

  • 10.1080/21551197.2012.678240


  • eng

Conference Location

  • United States