Medicine and Health Sciences Commons^™

The Impact Of Patient And Provider Education On Statin Therapy Initiation And Adherence In Type Ii Diabetics, Jane Harlan Bsn-Rn, Lindsey Jacobsen Bsn-Rn, Emily Easterly Bsn-Rn, Mitch King Bsn-Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes mellitus (T2DM) is a common, chronic disease that increases the risk of coronary artery disease and stroke fourfold, which makes protecting cardiac function a priority. The American Diabetes Association (ADA) and American Heart Association (AHA) recommend the prescription of statins to reduce cardiovascular complications. Unfortunately, provider and patient adherence to this recommendation is poor.This study aimed to determine if shared-decision making and patient follow-up within a 6 month period of being newly diagnosed with T2D has an effect on the initiation rate of statin therapy.

Methods

In this retrospective study we requested data from the University …

African American Women’S Perceptions Of A Group Based, Diabetic Medical Nutritional Therapy Intervention: A Qualitative Study, Megan Mcmahon, Laura Gray

DNP Scholarly Projects

Background: African American women exhibit lower rates of attaining recommended diabetes management goals such as optimal blood sugar, cholesterol, and blood pressure numbers compared to other racial and gender groups. As a result, they bear a disproportionate burden of the adverse outcomes associated with poorly managed type 2 diabetes, including increased complications and mortality rates compared to other demographic groups. Despite favorable qualitative findings regarding group-based interventions for African American women with other chronic diseases, a notable gap in the literature exists regarding the women’s perceptions of a group-based medical nutritional therapy tailored to type 2 diabetes. Purpose: This scholarly …

Effect Of Certified Diabetes Clinical Education Specialists On Adults With Type 2 Diabetes, Rachel Faller, Tracy Gregory, Michelle Jones, Peyton Barnett, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes mellitus affects 13.1% of adults living in Shelby County and over 30 million adults in the United States. This chronic disease creates a higher risk of macrovascular and microvascular complications for this population resulting in poor outcomes if not properly managed. Improving glycemic control can help to improve the quality of life for people living with diabetes and reduce healthcare costs. Currently 20% of funds spent in the United States on healthcare is utilized for diabetic care. Certified Diabetes Care and Education Specialists (CDCES) primarily educate patients about managing their diabetes, including health promotion that can …

Health Literacy And Diabetes Outcomes In Adults With Type 2 Diabetes In Southwest Virginia, Casandra Reyes Arellano

Epsilon Sigma at-Large Research Conference

Purpose: To determine if a quality improvement project involving individualized, one-on-one Diabetes education will improve health literacy and Diabetes outcomes in adults with Type 2 Diabetes in a rural primary care clinic. Diabetes is a chronic condition affecting the United States with 9.6% of Virginia’s population living with Diabetes.

Aims: To improve patient’s Diabetes literacy scores, BMI, and Hemoglobin A1c levels through Diabetes education.

Processes: There are pre- and post-education phases. Data to be collected at the end of both phases consist of DNT15 scores, BMI, and A1c. In the pre-education phase, BMI was obtained, DNT15 was administered, and Diabetes …

Diabetic Coaching Program To Improve African American Patients Glycemic Control, Shonda Moore

Student Scholarly Projects

Practice Problem: The purpose of the practice problem was to find out if, among African Americans with type II diabetes who are over 18, adopting a diabetic coaching program that emphasizes diet management can result in better glycemic control over 10 weeks than for those who do not receive coaching.

PICOT: In African Americans with type II diabetes over 18 years of age (P), does a diabetic coaching program on diet management (I), compared to no coaching program (C), improve glycemic control (O) over 10 weeks (T)?

Evidence: The evidence used to guide this project came from databases, including PubMed, …

Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc

Doctor of Nursing Practice (DNP) Projects

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

Using Empowerment Theory To Improve Understanding Of Type 2 Diabetes Mellitus In Haitian American Women, Balkys Bivins, Brenda Owusu, Indra R Hershorin, Tony Umadhay, Janet Joseph, Arvinder Singh

Nursing & Health Sciences Research Journal

Introduction: The CDC (2020) revealed that the age-adjusted prevalence of diabetes mellitus in the United States among the Black, non-Hispanic population is 16.8%. A study conducted by Bivins et al. (2021) revealed a 39% prevalence of type 2 diabetes mellitus (T2DM) among Haitian Americans (HAs) living in several states. In the literature, HAs are often grouped with Black Americans, yet Haitian American women (HAW) have unique struggles with treatment and management of T2DM. No prior study used the empowerment theory to improve the management of T2DM in HAW. Purpose: To improve the understanding of T2DM in HAW using empowerment theory. …

Enhancing Diabetes Care With Peer Mentorship And Support Groups, Barry Mccann Bsn, Rn

Posters & Presentations

Poster presented at the Parkview Nursing Research Symposium, 2023.

Continued increase in prevalence of type 2 diabetes indicates need for more effective interventions to support lifestyle and behavior changes (ADA 2018).

• Evidence indicates attending diabetes self management education programs can improve diabetes outcomes, unfortunately they are often under referred and underutilized (Powers et al. 2015, Boakye et al. 2018).

• Limited class times, locations, and capacities can make attendance for all patients difficult and vulnerable populations are less likely to participate (Boakye et al. 2018).

• Diabetes education programs often lack culturally and individually relevant guidance, provide no long-term …

Quality Improvement Project To Assist In Implementation Of Prediabetes Screen Protocol, Kyai Forney

Doctoral Projects

Prediabetes is a reversible condition that causes blood glucose levels to be higher than normal, but not high enough to be diagnosed as type 2 diabetes. When one has prediabetes, the cells in the body do not respond normally to insulin, and insulin acts like a key to letting blood sugar into cells to use energy. The pancreas produces insulin to try to get the cells to respond, but eventually, the pancreas has a challenging time keeping up, and the blood sugar level rises causing prediabetes (Lehrman, 2021). A person can have prediabetes for years with no obvious symptoms, so …

Implementation Of An Evidence-Based Diabetic Screening Tool In Rural Belizean Communities, Morgan Lee Taylor, Annelyse Caffrey

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Significance/Background: Type II Diabetes Mellitus (TIIDM) is a growing epidemic in Belize. The prevalence is increasing yearly, responsible for considerable health complications and deaths. Rates are much higher in Belize than in any other developing Central American country, and many rural citizens are undiagnosed and untreated. Access to healthcare is complex, and travel is often required in rural areas. Primary care visits in Belize are significantly less than in surrounding North and Central American countries. As a result, chronic illnesses such as TIIDM often go undiagnosed among children, adolescents, and adults- leaving TIIDM a leading cause of death in Belize. …

Mental Health Wellness In The Latino Population: Improving Phq-9 Scores In Depressed Patients With Comorbid Type Ii Diabetes, Amanda Cuellar

Doctor of Nursing Practice Final Manuscripts

Major depressive disorder is one of the most common mental health conditions. In the United States, 8.1% of the population have symptoms of depression. Patients with diabetes are 2–3 times more likely to experience symptoms of depression compared to the general population. Having these chronic conditions simultaneously can cause complications in both. The purpose of this study was to improve depression scores for patients who have comorbid type II diabetes. This project took place in a rural community with the Latino population. The nurse practitioner led an evidence-based practice project implementing treatment of depression with medication management, individual psychotherapy, and …

Establishing A Diabetes Self-Management Resource For The Self-Pay Client In A Rural Clinic, Emily Birkhead

Doctor of Nursing Practice Projects

Self-management of type 2 diabetes mellitus remains a prominent health concern across the United States. Adherence to treatment plans, medication, and glucose monitoring are often limited by out-of-pocket costs for the client. Diabetes Self-Management Education (DSME) is a set of domains that includes: medication adherence, glucose monitoring, nutrition, exercise, and effective coping mechanisms. DSME programs are provided across the United States helping those with Type 2 diabetes mellitus on their daily habits and management of the condition. DSME programs are largely unavailable to rural communities due to cost and distance barriers, resulting in diabetes education not being readily available in …

Implementation Of A Comprehensive Diabetic Foot Care Program In Primary Care, Peguy Sylvain

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Diabetes Mellitus is a growing health problem in America. Uncontrolled diabetes can result in vascularcomplications. One of the most common complications of diabetes is diabetic peripheral neuropathy. Early foot carescreening can help prevent Diabetic peripheral neuropathy and other complications such as skin injuries, burns, falls,infection, lower- extremity amputations, and peripheral arterial disease. Interventions that have been shown to improve theidentification of diabetes foot complications include staff education, screening and assessment, use of monofilament,tuning fork for diabetic foot assessment, patient education/ self-care, standardization, and use of electronic medical records(EMR)/electronic reminders.

METHODS: The Plan Do Study Act method of quality improvement …

Telehealth In Patients With Type 2 Diabetes Mellitus, Saghi Nassrouie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Description: Type 2 diabetes mellitus (DM2) is an epidemic that has many factors involved in its management to maintain control. Patients with DM2 require routine evaluations and blood work to provide comprehensive care. COVID-19 caused major shifts in traditional care which sparked an increase in the utilization of technology like telehealth. Telehealth can be an effective tool used to manage diabetes and help attain better glucose control, but its effectiveness during the COVID-19 pandemic warrants further investigation.Purpose: The purpose of this project was to determine if telehealth visits were more effective in reducing Hemoglobin A1c (HbA1c) in adult patients with …

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Formalized Diabetes Self-Management Education In A Safety-Net Clinic, Emanpreet Kaur

Culminating Experience Projects

Diabetes is a complex and chronic illness requiring continuous medical care with multifactorial risk reduction strategies (American Diabetes Association [ADA], 2021). More than 37 million Americans are suffering from diabetes and 90% of them have Diabetes Mellitus Type 2 (DMT2) (Centers for Disease Control and Prevention, 2021). The purpose of this article is to review the background, an organizational assessment, a literature review, and the results of the quality improvement project that took place at a safety-net clinic in the Midwest. This project included 16 patients and data was analyzed through descriptive statistics. Results include improved hemoglobin (Hg) A1c, Body …

Technology-Mediated Diabetes Prevention Program (Dpp) Benchmark Project, Devon Senical

MSN Capstone Projects

This benchmark project intends to broaden access to the Diabetes Prevention Program (DPP) by offering technology-mediated content at the primary care level because the Primary Care Physician (PCP) predominantly diagnoses prediabetes due to the recommendation by The U.S. Preventive Services Task Force (USPSTF) that nonpregnant overweight or obese adults aged 35 to 70 be screened for prediabetes and type 2 diabetes (Davidson et al., 2021). Thus, the primary care setting is the first opportunity to impact the conversion from prediabetes to type 2 diabetes. Of the 84 million people in the United States (U.S.) with prediabetes, they are estimated to …

Importance And Impact Of Diabetes Education On People With Diabetes, Nicole R. Glasco

MSN Capstone Projects

This paper aims to explain the significance and importance of why it is essential to offer patients with diabetes standardized education regarding their diabetes.

Improving Adherence To Annual Diabetes Guidelines In Rural Primary Care, Ashley Barney

Culminating Experience Projects

Background: The American Diabetes Association (ADA) (2022) identifies comorbidity risk assessments and treatment planning as key health maintenance components for diabetic patients. However, many providers do not adhere to the recommended national guidelines (Brenner et al., 2020).

Objectives: At a rural primary care clinic, the effectiveness of implementing a checklist was evaluated to improve provider adherence to the annual diabetes guidelines set by the ADA.

Methods: A quality improvement project was initiated and guided by the Lean Six Sigma framework. The checklist was implemented to assess if providers adhered to the recommended annual diabetes guidelines. The project …

Improving Annual Diabetic Foot Examinations At A Rural Primary Care Clinic, Michaela Moore, Shannon Harris, Christy Mnzava

Poster Presentations

The goal of this quality improvement project was to increase the number of adult patients who receive an annual diabetic foot examination through the education and training of clinicians and support staff.

Evaluating Education In Pregnant Women With Gestational Diabetes In Relation To Patient And Infant Outcomes, Lauren Young, Emily Abbott, Emilee Arsenault

Non-Thesis Student Work

Metabolic control and gestational diabetes can have significant impact on the health outcomes of new mothers and their newborns. This literature review focused on specifically on prenatal education and the impact to achieve adequate glycemic and metabolic control that affect health outcomes of women and their newborn. The goal of this literature review is to highlight the impact education has on gestational diabetes, and to promote positive health outcomes during pregnancy and postpartum. The CINAHL database was used to search the literature using keywords gestational diabetes, education, and patient outcomes. Exclusion criteria included women previously diagnosed with diabetes mellitus, and …

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Utilization Of Pressure Injury Prevention Team In Long-Term Care Settings, Riley Sullivan, Katie Seekins, Mia Stamey

Non-Thesis Student Work

In addressing the role that pressure injury prevention (PIP) teams can have in prevention and reduction of pressure ulcers for older adult patients in long-term care settings, this PICOT question is asked: In adults aged 65 and over in long-term care settings with a diagnosis of Type II Diabetes, does implementing weekly skin assessments performed by a pressure injury prevention (PIP) team to standard PIP strategies, compared to just standard PIP strategies, prevent or reduce pressure injury development over 6 months? Pressure injuries are a preventable complication that can lead to detrimental outcomes, including patients being “2.8 times more likely …

Nutritional Medicine: Education For Advanced Practice Providers, Natalie Organ

DNP Research Projects

Abstract

OBJECTIVE: The project's primary goal was to educate the APP and develop positive attitudes and beliefs concerning plant-based nutrition regarding obesity, diabetes, cardiovascular disease, and cancer. The project addressed a crucial gap in healthcare education. APPs were not routinely given the chance to learn nutritional medicine, leading to decreased confidence in providing nutritional guidance in clinical practice.

METHODS: The DNP project participants were practicing advanced practice providers. The Knowledge, Attitude, Behavior (KAB) education theory and CREATION Life were used. This project used Qualtrics to send a pre-and post-intervention survey titled Student Survey for Nutritional Medicine. The intervention was a …

Creating A Primary Care Track In Prelicensure Nursing Education, Janice E. Hawkins, Lynn L. Wiles, Jamela Martin, Beth Tremblay, Karen Higgins, Ingrid Mahoney

Nursing Faculty Publications

BACKGROUND: RNs practicing in primary care (PC) increase access to health care and contribute to better patient outcomes and cost savings, yet undergraduate nursing education traditionally focuses on disease-oriented care. This article describes a curricular track for infusing PC prelicensure programs.

METHOD: PC content is threaded across four semesters with targeted assignments and clinical experiences. Providing clinical immersion experiences with practicing RNs as preceptors in community and PC settings is a key component of this initiative.

RESULTS: Student feedback has been favorable. Students stated they gained insight to the role of RNs in PC through class assignments and clinical rotations. …

Providing Diabetes Education To Improve Staff Nurses' Knowledge, Marcia A. Patterson

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a chronic metabolic disease that affects over 34.2 million or 10.5% of the U.S. population and ranks as the seventh leading cause of death. Tennessee's diabetes prevalence rate is ranked 45th overall in the nation, with 14.9% of the population affected, and in the local area for this project, the rate is greater than 15%, creating a public health concern. Despite its prevalence, there is still a wide gap in knowledge among nurses on diabetes management. The practice-focused question for this project addressed whether a staff education program would improve nurses' knowledge regarding diabetes. The significant gap …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

Evaluation Of Universal Depression Screening In A Pediatric Diabetes Outpatient Clinic With The Integration Of A Depression Screening Tool Into An Electronic Health Record, Jenna Westberry

DNP Projects

Background: Depression is a significant problem for adolescents with chronic health conditions. Prevalence rates are two to three times higher in adolescents with diabetes compared to adolescents without diabetes (Badescu et al., 2016). Routine depression screening is not transpiring at rates and frequency recommended by the American Diabetes Association for this population. Implementing use of the Patient Health Questionnaire for all adolescents over the age of twelve years with Type 1 & Type 2 Diabetes Mellitus during routine health visits may improve early identification and diagnosis of depression and improve long-term health outcomes.

Purpose: The goal of this project was …