Date of Award

Summer 2022

Document Type

Final DNP Paper

Degree Name

Doctor of Nursing Practice (DNP)



Faculty Chair

Dr. Laura Walker


Background: Peripheral artery disease (PAD) is a narrowing or blocking of the arteries due to plaque buildup, which prevents oxygen, blood, and other nutrients from getting to the legs. When this buildup reaches a certain point, it becomes atherosclerosis, which is more prevalent in a smoker. Smoking intensifies the problem of plaque buildup if an individual already suffers from PAD. When an individual smokes, the nicotine causes the arteries to constrict and narrow, reducing blood flow further. The ankle-brachial index (ABI) is a simple, cost-effective diagnostic test to identify the presence of PAD which will improve patient outcomes.

Purpose: This DNP project aimed to increase routine screening for PAD in high-risk patients by utilizing an evidence-based screening protocol.

Methods: This process change project consisted of modifying the current process used in a cardiology clinic to increase screening of PAD in adult smokers. Data collected from a retrospective chart review before implementation of the protocol was compared to amount of screening that occurred following implementation of the protocol.

Results: There was a statistically significant increase (p=.0007) in rate of screenings from pre-intervention (3.4%) to post-intervention (47.6%). There was no statistically significant difference (p=.018) between the pre-intervention group (3.4%) and the post-intervention group (19.0%) on the detection of PAD.

Conclusion: This project showed the importance of identifying peripheral artery disease in high-risk patients and increased screening for peripheral artery disease in smokers aged 50 and older.

DNP Manuscript Defense Form.pdf (104 kB)
Manuscript Defense Approval Form



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