Date of Award

Spring 5-7-2021

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Ashleigh Heter

Second Advisor

Trina Larery

Third Advisor

Greg Belcher

Abstract

The purpose of the scholarly project is to: a) Evaluate if diabetes education can improve a patient’s overall condition; b) Measure the chances of reducing long-term complications if a person is to participate in diabetes education and continue to follow up; c) Demonstrate that with effective diabetes self-management education (DSME) hemoglobin A1c can be reduced. The project design and target population were selected based on research performed on diabetes and diabetes education and the effects that it has on improving self-management in turn creating better glycemic control and fewer complications. This study will focus on type 2 diabetes, which is a chronic disease that requires long-term treatment and self-management skills. The American Diabetes Association recommends the hemoglobin A1c be less than 7.0%, blood pressure be less than 140/90, LDL cholesterol be less than 70, be on a statin medication, and have a BMI of less than 25% (“Summary of Revisions,” 2018). The data was obtained from a retrospective chart review. With the review of data from a rural diabetes specialty clinic, it was determined if type 2 diabetic patients benefit from diabetes education to increase self-management skills in order to prevent long-term complications. The study found the average hemoglobin A1c for the patients that had participated in DSME was 7.3% whereas the patients that did not attend diabetes education was 8.6%. ADA recommends an A1c of less than 7% in order to reduce the risk of long-term complications. The average blood pressure of the patients that attended DSME met the recommendations provided by the ADA whereas the patients that did not attend DSME did not. Both groups met the ADA recommendations for LDL according to the average. There was a reduction of hemoglobin A1c in patients that attended DSME by 27% which is an average of a 2.02 hemoglobin A1c point reduction. There was a 2.2% reduction in BMI for those that attended DSME and a 27% reduction in LDL. When comparing blood pressure for the patients that attended DSME there was a 17% improvement in systolic blood pressure and a 13% reduction in diastolic blood pressure. The improvements seen in patients with DSME were significant when compared to the patients that did not attend DSME. The method used for this study was a retrospective chart analysis. A possibility for bias was that the sample was only looked at over a year’s timeframe and therefore may have had better or worse disease management if a different time frame was analyzed. Another limitation is that the sample evaluated may not reflect the type 2 diabetic population as a whole. With the data analysis, finding the mean of each variable studied was the best method to compare each sample against one another. This allowed for seeing the mean of each variable for both samples as well as the mean reduction for each sample. All diabetics should attend DSME at diagnosis and throughout the disease process to promote good health and good disease management. Healthcare providers should talk positively with their patients about DSME and the effects that it can have on their health and the management of the disease process. Advanced practice nurses should be well educated in DSME and the effects it can have on the patient’s future health and outcomes and encourage the patient to attend DSME and send any appropriate referral. The advanced practice nurse should also ensure to follow up on the referral to see if the patient attended and if the patient did not attend, then what were the barriers to attending. Discussing educational opportunities and the importance of education is crucial for the patient’s success. Advance practice nurses have the opportunity to decrease health care costs, promote good outcomes, and reduce the risk of long-term complications if pursue DSME with their patients.

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