Date of Graduation

Spring 5-20-2020

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions


Family Nurse Practitioner

First Advisor

Dr. Prabjot Sandhu

Second Advisor

Dr. Alexa Curtis


Background: In order to provide evidence-based preventive care to the aging population, Medicare began providing free annual wellness visits (AWVs) to its beneficiaries in 2011. The AWVs are a great opportunity for primary care providers to develop personalized preventive care as well as health promotion. However, many primary care practices especially those with limited resources struggle to incorporate AWVs into their busy primary care practice. Centers for Medicare and Medicaid Services allows other providers than physicians, NPs and PAs to perform those visits including registered nurses, health educators, and registered dietitians.

Methods: A pilot project was conducted with 12 patients using a RN/MA/physician team-based approach for AWV. Efficacy, satisfaction, and a cost benefit analysis was completed for analysis of the outcomes.

Results: Sixty-seven percent of the patients completed within one hour, and none of the visits required physician or other providers’ attention during the wellness visit. Ten out of 12 patients reported satisfaction about the visits conducted by the RN, and all staff members were satisfied with the process. The cost-benefit analysis for 0.2 FTE of RN will demonstrate that a clinic can expect the return on investment of 37.2% in the first year, and 52% thereafter.

Conclusion: Primary care practices are increasingly concerned about how to meet the demand of the aging population. Moving forward into the future, team-based approaches in primary care to conduct AVWs is necessary in order to provide preventive care to a larger sector of the population. Registered nurses are well poised to provide necessary assessment and screening for AWVs as well as an added opportunity to provide education during AWVs, and it can be a feasible option to utilize an RN to conduct AWVs.