Initiating Culturally-Directed Education For Hispanic Adults With Type 2 Diabetes Mellitus, Marie Davis, Jennifer Smith, Mandy Horner

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

BACKGROUND:

The U.S. Hispanic population has the highest rate of Type 2 diabetes mellitus (T2DM), which is influenced by socio-economic status and language barriers. Current evidence suggests that the delivery of culturally-directed Diabetes Self-Management Education (DSME) with the use of an interpreter can reduce diabetes-associated complications.

LOCAL PROBLEM:

The project took place at a free clinic in North Carolina. The purposes of this project was to create a culturally-directed DSME bundle for Hispanic adults with the use of a Spanish interpreter to improve understanding of T2DM management.

METHODS:

The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was …

Type 2 Diabetes Nutrition: A Video-Based Education Approach, Erin Russell

Culminating Experience Projects

Background: Type 2 diabetes mellitus (T2DM) is a chronic disease associated with life- threatening outcomes. To prevent such outcomes, people with diabetes must possess the knowledge and skills required to manage their chronic disease. Objectives: To evaluate the impact of video-based education (VBE) on participant Diabetes Self-Management Education Skills (DSMES). Methods: The experimental study was conducted in a primary care office in a Midwest state. A convenience sample of 55 participants was selected. Pre- and post-implementation surveys were administered to measure change in self-efficacy between DMSES scores after viewing the VBE intervention. The Wilcoxon Rank Sum test was performed using …

Barriers To Screening For Diabetic Retinopathy: A Scoping Review, Amy Cooper Rn, Bsn, Lajerica Bates Rn, Bsn, Julie Bridges Rn, Bsn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

More than 34 million people in the United States have diabetes. Diabetic retinopathy (DR) is a major complication of diabetes and a leading cause of vision loss. Risk factors for diabetic retinopathy include Type 1 and Type 2 Diabetes, hypertension, smoking, and being African American or Hispanic/Latino. This scoping review seeks to analyze the current research on ways to increase vision screenings, thus reducing cases of diabetic retinopathy in adults.

Methods

Between September 2020 and November 2021, a search was conducted using PubMed, EBSCOhost, Medline, and CINAHL to identify articles using keywords such as diabetic retinopathy and ophthalmology. This …

Optimizing Diabetes Self-Management Using Continuous Glucose Monitoring And Improving The Transition Of Care For Adult Patients Discharged From The Hospital, Nikki Rose Angeles

Doctor of Nursing Practice

Background: Diabetes mellitus is a chronic medical condition that affects more than 34 million Americans (Centers for Disease Control and Prevention, 2020). The financial impact of diabetes is significant. Americans spend $327 billion on direct medical costs to treat the disease and its associated complications (American Diabetes Association, 2018). The management of diabetes requires a multidisciplinary approach that involves healthcare providers, diabetes self-management support resources, and a high level of commitment from the patient. Patients with diabetes discharged from the hospital often receive fragmented and inconsistent information about managing their health issues. As they transition from hospital to home, their …

The Efficacy Of Tailored Text Messages To Improve Medication Adherence And Lifestyle Changes For Patients With Type 2 Diabetes Mellitus, Vanessa B. Silverio

Evidence-Based Practice Project Reports

Type 2 diabetes mellitus (T2DM) is a chronic disease characterized by increased amounts of glucose in the blood, and is the seventh leading cause of death in the United States (United Health Foundation [UHF]), 2021). T2DM can be effectively treated with medication and behavioral lifestyle modifications. Even small improvements in glycemic control can reduce the risk for debilitating complications such as heart disease, stroke, kidney disease, sepsis, and retinopathy (Wang et al., 2021, Haider et al., 2019). The purpose of this evidence-based practice (EBP) project was to identify the most effective intervention for improving medication adherence, lifestyle changes, and hemoglobin …

Evaluating The Use Of A Diet Screening Tool For Diabetes And Weight Management In Primary Care, Christie Mcbride

DNP Projects

Background: Type 2 diabetes mellitus is a prominent disease and leading cause of death in the nation. Many complications can develop when glucose levels are poorly controlled. When patients receive education and support in diabetes self-management, including individualized dietary interventions, it leads to improved glycemic control.

Purpose: The purpose of this quality improvement (QI) project was to evaluate the incorporation of a diet recall tool, Starting the Conversation (STC), in the standard care for diabetic patients with abnormal body mass index (BMI). The study aimed to examine: (1) patient opinion of the intervention and (2) healthcare provider satisfaction with use …

Type 2 Diabetic Education Benchmark Study, Amy Lynd

MSN Capstone Projects

Evaluating the implementation of verbal and written education on diet for newly diagnosed type 2 diabetics.

Implementing Tele-Coaching Diabetes Education To Improve Self-Care And Clinical Outcomes For Patients With Type 2 Diabetes, Sori Jung

DNP Research Projects

Abstract

Background: Type 2 diabetes (T2DM) requires initial and continuous patient education for lifelong management due to the complexity of the disease. However, diabetes education is not very well-supported in the office setting due to the providers’ limited time per patient. However, with the aid of technology-based intervention, patients can be more supported and educated, leading to better T2DM control.

Aims: The purpose of this scholarly project was to evaluate the effectiveness of diabetes education through tele-coaching in patients with T2DM for improved self-care and clinical outcomes, including hemoglobin A1c (A1c) and body mass index (BMI).

Method: A mixed-method, single …

Telehealth Coaching To Improve Exercise Self-Efficacy In Diabetics, Oby C. Ikoro

Doctor of Nursing Practice (DNP) Projects

Abstract

Background and Review of Literature: Exercise is essential to the self-management of Type 2 Diabetes Mellitus (T2DM). The literature reveals that many patients with difficulty in the self-management of exercise improve with coaching. The literature also reveals that an adequate exercise routine results in improved blood glucose control and the prevention of complications.

Purpose: This DNP project aims to demonstrate the positive effect of low-cost telehealth coaching to improve self-efficacy in an exercise regimen for T2DM patients.

Methods: A one-group pretest-posttest design was used in this project. Telephone calls and text messaging were used to coach patients to improve …

Evaluation Of Pharmacist- Or Nurse-Driven Long-Acting Insulin Titration Protocol In Adult Primary Care Patients With Type 2 Diabetes, Ruth Manzi, Corinn Martineau, Carmine Laporta, Mary Muca, Samantha Marrier, Donald Medd, Jennifer Aronson

Journal of Maine Medical Center

INTRODUCTION

Studies have supported protocolized insulin titration to optimize insulin therapy. We implemented a long acting insulin titration (LAIT) protocol in a primary care setting to aid patients achieve optimal control of their diabetes. The purpose of the study was to evaluate the performance of the LAIT protocol.

METHODS

This retrospective analysis included patients ≥18 years with type 2 diabetes (T2D) and a hemoglobin A1c (A1C) >8% who were managed as outpatients at clinics within our health care system. We collected demographic and clinical data before and after a patient’s enrollment in the LAIT protocol. Our primary outcome measure was …

Supporting Positive Lifestyle Changes Among Patients With Diabetes Mellitus Type 2, Alison Tynan

Nursing | Senior Theses

The following thesis is a compilation of literature reviewed to formulate background research for a pilot study. The literature reviewed pertains to the potential benefit of added case management for patients with diabetes mellitus type 2. A proposed pilot study, based off of this research, aims to identify topics, tools, facts, and changes that can be made to case management to improve not just the biological aspects, like HbA1c levels, but the mental and emotional as well to allow for whole person care.

The primary question being asked is “what types of support do people with diabetes mellitus type 2 …

The Effect Of Care Coordination On Hemoglobin A1c For Type 2 Diabetes Patients, Lee Ann Hinsky

Electronic Theses and Dissertations

The purpose of the study was to test the impact of care coordinator visits by primary care registered nurses on serum hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes. In the study, the researcher compared 2 groups of type 2 diabetes patients—those who had care coordinator visits from registered nurses and those who did not—through retrospective data collection and analysis from the patients’ electronic medical record from July 2018 through December 2018. An independent samples t test was used to compare the means of the intervention and control groups’ change in HbA1c levels. The intervention and control groups …

Improving Diabetic Foot Screening In A Primary Care Clinic For Homeless Adults: A Quality Improvement Project, Theresa Causa

Doctor of Nursing Practice

The purpose of this project was to increase the adherence of clinic providers at the homeless primary care clinic by implementing the American Diabetes Association Clinical Guidelines for the evaluation and management of Type 2 diabetes with foot care. Type 2 diabetes is a chronic condition that affects 13% of the Texas adult population (Centers for Disease Control and Prevention, 2014). The homeless person's main method of transportation is walking. The complications of undiagnosed foot problems include reduced mobility, pain, lower limb amputations, and difficulty controlling chronic diseases including diabetes and depression. Provider responsibilities include screening for diabetes in all …

Implementation Of Ace Inhibitor Regimen In Patients With Type 2 Diabetes Mellitus, Rita Chukwurah

Doctor of Nursing Practice

The incidence of type 2 diabetes has increased dramatically and is associated with many problems, including chronic kidney disease. The purpose of this quality improvement project was to implement two evidence-based guidelines that may detect chronic kidney disease and slow its progression in patients with type 2 diabetes by implementing angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy according to evidence-based guidelines from the American Diabetes Association. Patients with type diabetes were screened for microalbuminuria and eGFR of < 60 mL/min/1.73 m². Based on lab results, the provider recommended either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker to patients with as …

Evaluation Of Depression Screening By Providers For Adult Patients With Type 2 Diabetes In Primary Care, Kristy M. Bryant

DNP Projects

BACKGROUND: Depression in adults with type 2 diabetes can lead to non-adherence to self-management behaviors and treatment recommendations, and ultimately worse health outcomes. Currently, only 50% of adult patients with type 2 diabetes treated in the primary care setting are screened for depression. Without screening for depression, a diagnosis of depression and subsequent treatment is likely to be missed and the patient is more likely to experience worse health outcomes and worse quality of life.

PURPOSE: The purpose of this study was to evaluate impact of provider education on improving screening rates for depression in adult patients with type 2 …

A Process Improvement Project To Increase Diabetic Retinopathy Screening Rates As Evidenced By Formal Documentation, Michelle Renae Campbell

DNP Projects

Purpose: To evaluate the effects of a referral process on diabetic retinopathy screening rates among patients with Type 2 diabetes and formal documentation completion rates of these screenings within a primary care setting.

Methods: A referral process for patient referral to an ophthalmologist for annual diabetic retinopathy screening was instituted for a 4-week period within a Norton Community Medical Associates (NCMA) primary care location for Type 2 diabetes patients. Charts of 30 patients pre-intervention were compared with the charts of 30 patients seen during the intervention phase of the study to evaluate the effects of the referral intervention. Demographic data, …

An Evaluation Of The Screening And Management Of Patients With Type 2 Diabetes, Laura A. Cahoe

DNP Projects

Purpose: This purpose of this project was to evaluate preventive screening practices and adherence to guidelines for patients with type 2 diabetes (T2DM) as recommended by the American Diabetes Association (ADA) and United States Preventive Services Task Force (USPSTF) in the primary care setting. The specific aims were to: 1) determine the percentage of patients who received recommended screenings from the ADA, 2) determine the percentage of patients who received recommended screenings from the USPSTF, and 3) determine if the proportion of patients to receive the recommended screenings met established benchmarks set by Healthy People 2020 (HP2020).

Methods: A retrospective …

Measuring Providers’ Adherence To The American Diabetes Association Screening Recommendation For Prevention Of Diabetic Nephropathy, Whitney R. Munroe

DNP Projects

Purpose: The purpose of this study was to evaluate provider adherence to the ADA’s recommendation for an annual screening urinary albumin excretion level to check for the presence of microalbuminuria. A secondary objective was to assess for adequate treatment (i.e. ACE inhibitor or ARB prescription) in those patients with microalbuminuria present.

Methods: A retrospective chart review was conducted on 60 randomly selected patients seen within a primary care practice in an urban university setting between January 1^st, 2014 and December 31^st, 2014. Inclusion criteria included age ≥ 18 years and an active diagnosis of type 2 …