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 …

Diabetes Prevention And Management Education For Punjabi-Sikh Older Adults, Mandeep K. Gill

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: South Asians from Bangladesh, Pakistan, and India have a higher prevalence of diabetes than the general global population and are also more susceptible to developing diabetes due to biological and lifestyle factors. The South Asian diet is high in refined grains and monounsaturated fatty acids, increasing the risk of diabetes.

Local Problem: Congregants of a Sikh gurdwara (place of worship) lacked knowledge of diet and lifestyle in relation to preventing and managing diabetes. Many senior congregants have been diagnosed with diabetes or are at high risk of developing the disease.

Methods: Knowledge of diabetes prevention and management were …

Continuous Glucose Monitoring And Diabetes Management During Pregnancy, Nicole Beamish

Doctor of Nursing Practice (DNP) Projects

Continuous Glucose Monitoring and Diabetes Management During Pregnancy

Abstract

According to the Scope of Practice, Standards of Practice, and the Standards of Professional Performance for Diabetes Educators, registered nurses play an integral role in the promotion of diabetes self-management education and training in diabetes care (AADE, 2017). This paper upholds the standards set forth by the American Association of Diabetes Educators (2017) governing body, to stimulate the process of peer review, promote documentation of the outcomes of diabetes self-management education and training (DSME/T), encourage research to validate practice and improve quality DSME/T and diabetes care for pregnant women who use …

Eliminating Barriers To Chinese American Diabetic Patients: Implementation Of Diabetic Cantonese Group Visits, Sabrina Wong

Doctor of Nursing Practice (DNP) Projects

Problems: Asian Americans have higher incidence and prevalence of diabetes mellitus type 2 and less preventive care and higher complication rates than the rest of the American population.

Context: According to the National Healthcare Quality and Disparities Reports (2016), Asian Americans are more likely to be diagnosed with diabetes compared to non-Hispanic whites by over ten percent.

Interventions: A comprehensive group visit program was implemented in a clinic in Oakland, Chinatown catered towards Cantonese-speaking diabetic patients. The group visit included culturally and linguistically appropriate materials related to nutrition, exercise, and diabetes knowledge. Each cohort attended a ninety-minute group visit session …

Healthcare Provider Education: Adult Jamaicans With Type 2 Diabetes, Patricia Anderson

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Worldwide prevalence of type 2 diabetes mellitus (T2DM) among the Jamaican population is 11.9% (WHO, 2016). Jamaican patients and their families have experienced first-hand the debilitating complications of this deadly disease.

Context: Jamaicans with diabetes who live in the US experience these same complications. Approximately 300,000 Jamaicans live in Florida (Peart, 2020). This change of practice project was conducted with healthcare providers employed in a family medicine clinic in Florida that treat Jamaicans with T2DM.

Intervention: This change of practice project used an online evidence-based educational training (i.e., Jamaican culture, diet, and health beliefs and how to use …

Improving Insomnia With Digital Cognitive Behavioral Therapy In Patients With Diabetes, Patricia Lunardi

Doctor of Nursing Practice (DNP) Projects

Background: Managing and treating insomnia in patients with diabetes mellitus requires the examination of current literature of evidence-based research implementing pharmacological and non-pharmacological interventions. This QI project focused on the implementation of Cognitive Behavioral Therapy for Insomnia (CBT-I). Purpose: The purpose of this project was to implement CBT-I in adult patients with diabetes mellitus (DM) and examined whether it alleviated their insomnia symptoms using the Pittsburg Sleep Quality Index (PSQI) tool. Methods: The study used a one-group pre-test and post-test intervention design; the intervention is a free application, “CBT-i Coach”. 20 participants were invited to participate from an Endocrinology …

A Quality Improvement Project To Implement Shared Medical Appointments For The Management Of Type 2 Diabetes In Latino Patients, Denisse Maldonado

Doctor of Nursing Practice (DNP) Projects

Problem: Santa Rosa Community Health (SRCH) is one of the largest federally qualified health centers in Northern California, providing health care to more than 30,000 patients. More than half of the patients receiving care at the SRCH Lombardi site are Latino patients. Patients self-identify as Latino or other ethnicity on the initial health center registration form. SRCH serves 964 patients with diabetes. Due to limited access to appointments and resources, seeing a healthcare provider regularly can be difficult, posing a barrier to diabetes management. Patients with diabetes would greatly benefit from regular appointments with their primary care provider and resource …

Improving Latino Diabetes Patients' Physiologic Measurements Utilizing Culturally Competent Interventions, Christine Hoogasian

Doctor of Nursing Practice (DNP) Projects

Latinos have a high risk of developing poorly controlled type 2 diabetes, which may be at least partly due to their cultural beliefs. Many health care clinics lack consistent use of culturally competent educational interventions when providing diabetes education to Latinos. The literature demonstrates that clinics using culturally competent interventions tend to accomplish significant clinical improvements in outcomes such as lower glycosylated hemoglobin (A1C) levels, weight loss, increase in daily steps walked, and improved diabetes knowledge. The purpose of this Doctorate of Nursing Practice (DNP) project was to use Latino-tailored culturally competent diabetes education to achieve a reduction in weight, …

Increasing Exercise For Patients With Diabetes Using A Mobile App – A Quality Improvement Project, Jill Jolin

Doctor of Nursing Practice (DNP) Projects

Background: A literature review on Type 2 Diabetes Mellitus (T2DM) indicates that a combination of aerobic and resistance exercise leads to overall beneficial physical and psychological health benefits for people that have a diagnosis of Diabetes. Behavior change and social support are identified as essential factors that facilitate and help maintain a productive and committed exercise program for people with Diabetes. Patient self-management is an important indicator in maintaining good control of diabetes, and mobile phone interventions have been shown to improve such self-management. Exercise is an important component of treatment, and prevention of T2DM although people struggle with incorporating …

Higher Fat Low Carbohydrate Diet To Improve Health Related Quality Of Life For Overweight Or Obese Diabetics In A Primary Care Clinic, Breck Baker

Doctor of Nursing Practice (DNP) Projects

Diabetes and obesity are chronic diseases that affect individuals worldwide. The American Diabetes Association (ADA) and the American Heart Association (AHA) have developed guidelines for management of diabetes and obesity. The DNP student examined the use of the Higher Fat Low Carbohydrate (HFLC) diet, which conflicts with these frequently used guidelines. The literature on a HFLC diet suggests positive effects for type 2 diabetics, including weight loss, improved HA1c, lower BMI and no detrimental impact on metabolic markers such as cholesterol, triglycerides, or low and high density lipoproteins. The purpose of this project was to provide type 2 diabetics who …

Implementation Of Food Insecurity Screening In Clinical Setting, Florence Ngozi Soba

Doctor of Nursing Practice (DNP) Projects

This project used the Stetler model of research utilization framework to apply evidence-based findings to clinical settings screening adults with type II diabetes mellitus (T2DM) and low incomes for food insecurity. The project involved the review and critical appraisal of research studies and translation of research-based knowledge into a protocol for the Peach Tree Clinic with respect to the impact of food insecurity on diabetes outcomes in adults with T2DM and low incomes who were at risk of food insecurity. In addition, the proportion of screened at-risk patients who received nutritional counseling was calculated. The proportion of patients with T2DM …

Evidence-Based Change In Practice: Development And Implementation Of Type Ii Diabetic Flow Sheet, Kathryn Grimleybaker

Doctor of Nursing Practice (DNP) Projects

Ten percent of the National Health Service annual budget goes to treat complications from diabetes (Lancet, 2010). The American Diabetes Association® (ADA, 2013) estimated that diabetics in the United States incur $176 billion annually in direct medical costs for treatment with hospitalization being the main component of the expenditures. California has the largest population of diabetics and the highest annual cost at $27.6 billion (ADA, 2013). The Healthcare Cost and Utilization Project (HCUP, 2008) found that the average cost of hospitalization in 2008 for a patient with diabetes was $10,937 in contrast to $8,746 for a patient without diabetes. The …