Medicine and Health Sciences Commons^™

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 …

Hemoglobin A1c And The Diagnosis Of Diabetes And Prediabetes In Children And Adolescents, Jennifer Mcguire Hitt

Theses and Dissertations (ETD)

Although the American Diabetes Association (ADA) adopted the use of the glycated hemoglobin (A1C) test as a method of diabetes and prediabetes diagnosis, the ADA has not developed firm guidelines concerning the use of the A1C test in children and adolescents, as research has not validated thresholds in this group. Diabetes and prediabetes are diseases influenced by multiple factors, including race and ethnicity, age, vitamin D deficiency, and body mass index (BMI). The purpose of this study was to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the A1C test compared to the gold …

Management Of A Dka Patient With Severe Metabolic And Ketoacidosis With Chronic Renal Insufficiency, Brian Albany

Nursing Student Class Projects (Formerly MSN)

Diabetic ketoacidosis (DKA) serves as one the leading causes of mortality in diabetic patients [14]. The mortality has decreased over the past several decades due to the rapid recognition of the disease state and the improvement of management of DKA [14]. Despite a decline in mortality rates over the past twenty years from 7.96% to 0.67%, errors in management of the disease state are associated with significant morbidity and mortality [2]. Utilization of DKA protocols in the acute care setting have allowed congruency in care and delivery of effective lifesaving treatment. Despite advances in standardized DKA protocols, there still remains …

Incretin Hormones And Their Effects In Type 2 Diabetes, Molly Getz

Nursing Student Class Projects (Formerly MSN)

Type 2 diabetes mellitus (T2DM) is a progressive disease characterized as having pancreatic β-cell dysfunction, insulin resistance and hyperglycemia (Stephens, 2010, p. 491). T2DM affected 29.1 million Americans or 9.3% of the population in 2012 and was the seventh leading cause of death in the United States in 2010 ("ADA Statistics," 2014), with many of these patients finding it difficult to achieve or maintain adequate glycemic control despite making lifestyle changes and pharmacologic interventions (Freeman, 2007). Disease management of T2DM requires a comprehensive plan including medication therapy, education and active involvement of the patient, with the goal of therapy to …

Necessity For Excellent Glycemic Control Before, During And After Cabg Surgery, Sheri Clouse

Nursing Student Class Projects (Formerly MSN)

A 72 year old male patient was admitted to the hospital presenting with sharp substernal pain and pressure to the left upper chest rated a “10” out of 10. Patient complained of chest pain even at rest which was relieved by a nitroglycerin infusion. Patient had established coronary artery disease as evidenced by five prior stent placements, with the last stent placement being in 2010. The patient also presented to the Emergency Room with a blood glucose level over 600 mg/dL and because of his complaints of chest pain, was transferred to a neighboring hospital facility to have a cardiac …

Impact Of Text Messaging On Diabetic Foot Self-Care Behaviors Using A Single-Case Design, Stephanie Charese Hills

Nursing Theses and Dissertations

Problem: The absence of diabetic foot self-care is one of the major reasons for the approximately 60,000 avoidable lower extremity amputations annually in the U.S. Providers have limited time during clinic visits to educate their patients and increase awareness. Innovative strategies beyond the clinical setting are necessary to reinforce self-care behaviors. Objective: The purpose of this study was to use an innovative design method to examine the impact of providing diabetic foot care education to patients via text messaging and to assess the effect on patient self-care behaviors and clinical outcomes. Methods: Quantitative research using a single case study design. …

Promoting Behavior Changes In Patients With Type 2 Diabetes Through Shared Medical Appointments, Shonda Lanette Williams

Doctoral Projects

Diabetes Mellitus (DM) is a chronic disease that affects many individuals in the United States. It was reported that a total of $245 billion is spent annually on both direct and indirect health care costs associated with the treatment of diabetes and diabetic related complications. Diabetes related complications can be prevented or delayed if proper education is done and individuals are willing to practice positive behavior changes and self-manage their disease. The purpose of this doctoral capstone project was to promote behavior changes in patients with diabetes through diabetes self-management education (DSME) in shared medical appointments (SMAs).

This project was …

An Evaluation Of The Effectiveness Of Providing Foot Care Education In A Rural Clinic Setting, Gloria Green-Morris

Doctoral Projects

Diabetes is one of the most frequently diagnosed metabolic disorders and is currently at pandemic magnitude. Approximately 1.4 million adults are diagnosed with diabetes each year. According to the American Diabetes Association (2011), the numbers of diagnoses will more than double by 2030. Because of the high prevalence of diabetes, the perceptions of risk factors and healthy behaviors are important. A good understanding of written and verbal healthcare instructions, healthcare accessibility, and socio-economic status have a direct effect on patient health outcomes and the overall health of the population (Jovic-Vranes, Bjegovic-Marinkovic & Marinkovic, 2009).

Diabetic foot complications are common concerns …

Portion Size Selection In Relation To Hemoglobin A1cs, Brian L. Dixon

Undergraduate Honors Theses

Obesity has been recognized as an increasing issue within our country. Obesity contributes to many health related issues, including type 2 diabetes mellitus. Portion size is a factor that has generated clinical research interest. The aim of this study was to determine if there was a relationship between management of diabetes measured by hemoglobin A1c and portion size selection for type 2 diabetics. In this study, subjects selected portion sizes of four different foods. Data were compared to recent A1c levels. Due to the small sample size, nonparametric statistical analysis was used. The relationship of grain portion weight selection and …

The Utility Of The U.S. Diabetes Conversation Map As An Intervention To Promote Diabetes Self-Management Adherence, Lisa Gale Jones

Theses and Dissertations--Nursing

Diabetes has reached epidemic levels, to the currently estimated 29 million individuals who are living with diabetes. Those with diabetes must manage their disease through a combination of medication, physical activity recommendations, and nutritional guidelines. The consequences of non-adherence to recommendations include cardiovascular disease, kidney failure, vision loss, or ultimately, death. Despite the risks of non-adherence, individuals often do not adhere to recommended treatment. Researchers have attempted to identify strategies to promote diabetes self-management adherence, thereby decreasing complications related to the disease.

Specific Aims:

1. describe the factors that prohibit individuals from adhering from diabetes self-management behaviors as well as the …

The Impact Of Insulin Management On Quality Of Life In Type 2 Diabetes, Sandra Ellen Mccormick

Dissertations

Complications of type 2 diabetes (T2DM) are severe but can be minimized through excellent glycemic control, optimally achieved by using intensive, or basal-bolus, insulin management. The quality of life (QOL) effects of basal-bolus insulin management are not fully known. This cross-sectional, observational study was based on the Revised Wilson and Cleary Model for Health Related Quality of Life, which measures five QOL domains (biological function, symptoms, functional status, general health perceptions, and overall QOL). The study aims were to describe, compare, and predict QOL in persons with T2DM based on type of insulin management (oral meds only, basal insulin only, …

The Development Of The Barriers, Elizabeth Hagelsieb-Escalera

Open Access Theses & Dissertations

Estimates of undiagnosed diabetics are as high as 50%. Early intervention and management can reduce the complications of diabetes; however, this is possible only after the disease has been diagnosed. A review of diabetes screening literature revealed a dearth of information regarding the diabetes screening behavior of individuals. Unlike barriers to cancer screening, little is known about barriers and facilitators to diabetes screening. The theory of planned behavior (TPB) is a logical theoretical framework to apply for the examination of screening intentions because it allows inference of behavioral predictors via survey item responses. Using the TPB framework, the Barriers and …

Can Follow Up Phone Calls Decrease Complications Of Chemotherapy Toxicities In Adults?, Maire M. Blankenship

Doctor of Nursing Practice Technical Reports

Approximately 22% of all cancer patients in the United States receive chemotherapy. Older adults account for 60 % of new cancer diagnoses in the United States. The aging process is associated with comorbidities that potentially can increase toxicities associated with chemotherapy. These include coronary artery disease, hypertension, and diabetes. Monitoring for toxicities during treatment and intervening when needed allows patients to move forward in their treatment plan. Interruptions in the treatment plan have the potential to adversely affect treatment goals. The purpose of this study is to determine if patients receiving phone calls on predetermined days had fewer days of …

Knowledge Of The Risks Of Heart Disease In Uninsured And Insured Persons With Diabetes In A Rural Community In Southeastern United States, Lisa S. Howard

Nursing Theses and Capstone Projects

Diabetes and heart disease are chronic illnesses affecting many lives in the United States. Both diseases have complications, and when coupled together, the mortality rate and risk of complications increase. Heart disease is the leading cause of death in most countries across the world, and the majority of individuals diagnosed with diabetes die of a heart disease complication. Literature review reveals a plethora of research regarding the relationship between diabetes and heart disease, but limited research was found regarding health disparities with diabetes and heart disease awareness. No research was found assessing the knowledge base regarding diabetes and heart disease …

African American Race And Culture And Patients' Perceptions Of Diabetes Health Education, Linda Marie Keenan

Walden Dissertations and Doctoral Studies

African Americans diagnosed with diabetes are less likely to self-manage diabetes-specific modifiable risk factors. As a result, utilization of healthcare services occurs at a greater rate than other racial groups, and thereby incurs higher than expected healthcare costs. This ethnographic study explored the elements of diabetes educational material African Americans in a large city in the southern part of the United States found most useful to facilitate self-management of their disease. Bandura's self-efficacy theory provided the theoretical framework. Research questions addressed the preferred educational content, layout of material, and methods for educational delivery and caregiver support. A purposive sample of …