Implementing Effective Care Through Utilization of Diabetes-Focused "Right Care" Visits in a Suburban Primary Care Setting.
| Autor: | Neu, Tricia, Eppley, Christopher, Gianelis, Kristin |
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| Předmět: |
DIAGNOSIS of diabetes
TREATMENT of diabetes MEDICAL quality control REPORTING of diseases GLYCOSYLATED hemoglobin PILOT projects GLYCEMIC control DIABETES SUBURBS MEDICAL screening QUANTITATIVE research PRIMARY health care QUALITATIVE research COMPARATIVE studies HUMAN services programs QUALITY assurance DRUGS HEALTH care teams PATIENT education PATIENT compliance NURSING interventions |
| Zdroj: | Journal of Doctoral Nursing Practice; 2023, Vol. 16 Issue 2, p139-149, 11p |
| Abstrakt: | Background: Diabetes is the seventh leading cause of death in the United States and the leading cause of lower limb amputations, adult-onset blindness, and renal failure. It is estimated that 34.2 million Americans have a diabetes diagnosis, and the prevalence of this condition has continually increased over the last two decades. This study includes patients at a large, suburban primary care practice in southwest Ohio who were considered to have uncontrolled diabetes based on their last Hemoglobin A1c of greater than 9%. Compliance with recommended annual screenings among this population was 15%. Objectives: The aim of this project was to improve glycemic control and increase the number of patients who received the recommended annual screenings through the implementation of nurse practitioner-driven, diabetes-focused "Right Care" visits.C Methods: This quality improvement pilot study consisted of interventions implemented over the four plan-do-study-act cycles. Each cycle included a test of change that was identified based on data from previous cycles to ensure continuous improvement throughout project implementation. Four interventions were evaluated including the utilization of a diabetes registry, implementation of a "Right Care" checklist during "Right Care" visits, use of a patient engagement tool with a focus on individualizing diabetes medication regimens, and implementation of a team-engagement plan. Results: Average Hemoglobin A1c reduction was 2.4% post-"Right Care" visit. Compliance with the annual screening bundle increased to 44% over 8 weeks. Utilization of the patient/provider relationship increased visit compliance by 18%, and the team engagement plan decreased work-related stress by 12%. Conclusions: The implementation of "Right Care" visits led to improved glycemic control and increased compliance with the recommended annual screenings among patients with an A1c greater than 9%. The patient engagement tool identified key factors related to diabetes medication adherence and team engagement decreased work-related stress and improved annual fundoscopic exam screening compliance. Implications for Nursing: Nurse practitioner-led "Right Care" visits utilize the knowledge and skills of advanced practice registered nurses to improve glycemic control in patients with uncontrolled diabetes. [ABSTRACT FROM AUTHOR] |
| Databáze: | Supplemental Index |
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