Improving Diabetic Care Through Education and Innovation.

IF 0.2 Q4 NURSING
Riki J Williamson, Renea Powell, Andrea K Shepherd
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Abstract

Background: Despite the innovative advancements in diabetes care, providers may not recognize patients with type 2 diabetes mellitus (T2DM) who qualify for a continuous glucose monitoring (CGM) device or the benefits of a telemedicine program for improving self-management behaviors. Objective: This quality improvement (QI) project aimed to determine if an advanced practice registered nurse (APRN)-led telemedicine program using CGM could improve glycemic control and self-management in patients with insulin-dependent T2DM. Methods: A 6-week telemedicine program was developed and implemented using the CGM's time-in-range to deliver patient-specific education. Clinical metrics were collected at each visit. All patients completed a pre- and postintervention Diabetes Self-Management Questionnaire-Revised (DSMQ-R) survey. Results: A repeated measures analysis of variance revealed that the telemedicine program had a statistically significant impact on time-in-range outcomes, F(2, 14) = 18.203, p < .001. Paired-samples t tests indicate that APRN-led education improved body mass index, t(8) = 4.232, p = .002; decreased systolic blood pressure, t(8) = 2.90, p = .010, and diastolic blood pressure, t(8) = 3.21, p = .007; and increased self-management skills as evidenced by DSMQ-R, t(8) = -5.498, p < .001. Conclusions: This QI project highlights multiple interventions for improving diabetes management in a primary care facility. Implications for Nursing: An APRN-led telemedicine program integrating CGM time-in-range data can improve glycemic control and self-management skills in patients with T2DM who administer insulin.

通过教育和创新改善糖尿病护理。
背景:尽管糖尿病护理取得了创新性进展,但医疗服务提供者可能无法识别符合连续血糖监测(CGM)设备使用条件的 2 型糖尿病(T2DM)患者,也无法识别远程医疗项目对改善自我管理行为的益处。目标:该质量改进(QI)项目旨在确定由高级执业注册护士(APRN)领导的使用 CGM 的远程医疗项目能否改善胰岛素依赖型 T2DM 患者的血糖控制和自我管理。方法:制定并实施为期 6 周的远程医疗计划,利用 CGM 的时间范围提供针对患者的教育。每次就诊都会收集临床指标。所有患者都完成了干预前后的糖尿病自我管理问卷-修订版(DSMQ-R)调查。结果重复测量方差分析显示,远程医疗项目对时间范围结果有显著的统计学影响,F(2, 14) = 18.203,p < .001。配对样本 t 检验表明,APRN 主导的教育改善了体重指数(t(8) = 4.232,p = .002);降低了收缩压(t(8) = 2.90,p = .010)和舒张压(t(8) = 3.21,p = .007);DSMQ-R 证明提高了自我管理技能(t(8) = -5.498,p < .001)。结论:该 QI 项目强调了在初级保健机构中改善糖尿病管理的多种干预措施。对护理工作的启示:由全科护士领导的远程医疗项目整合了 CGM 时间范围数据,可以改善使用胰岛素的 T2DM 患者的血糖控制和自我管理技能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
45
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