Date of Award


Degree Type


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Karen Burritt PhD, RN

Second Advisor

Anne M. McKay DNP

Third Advisor

Alex Nesterenko


Fragility fractures and secondary fractures are a large physical, financial, and emotional drain on the individuals and families affected. Improving post fragility fracture care and increasing follow-up rates with specialty services, such as a fracture liaison service, may promote post-fracture recovery and help prevent future fractures. The purpose of this doctoral project was to increase and improve post osteoporotic fracture care by increasing appropriate referrals and follow-up care. Patient data was retrieved and analyzed on 60 fragility fracture patients referred to a local fracture liaison service. The analysis found that patient gender, fracture site, and history of a previous fracture all played a significant role as to whether the patient would follow-up with a fracture liaison service. The Health Belief Model and the Donabedian model were used to help drive this project and provide structure to the next steps in the project. To make the results relevant to primary care providers, local outcome data was used to provider a presentation to the group. The primary care providers then completed a survey answering questions based on their impression of the patient data presentation. The provider survey response data was then analyzed for trends. Most notably, the vast majority of providers agreed that after the presentation, they had a greater understanding of the patients that were most likely to receive inadequate fragility fracture care or refuse follow-up with a fracture liaison service. This implies that the providers now have a raised awareness about these patients and fewer patients will fall through the cracks when it comes to fragility fracture care and fracture liaison service follow-up. This project format could be applied to other populations to assist in revealing each unique population’s characteristics that impact fragility fracture care and fracture liaison service follow-up. Those results could then be presented to local primary care providers to raise awareness and improve their local outcomes.