Riki J Williamson, Renea Powell, Andrea K Shepherd
{"title":"Improving Diabetic Care Through Education and Innovation.","authors":"Riki J Williamson, Renea Powell, Andrea K Shepherd","doi":"10.1891/JDNP-2023-0060","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> 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. <b>Objective:</b> 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. <b>Methods:</b> 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. <b>Results:</b> A repeated measures analysis of variance revealed that the telemedicine program had a statistically significant impact on time-in-range outcomes, <i>F</i>(2, 14) = 18.203, <i>p</i> < .001. Paired-samples <i>t</i> tests indicate that APRN-led education improved body mass index, <i>t</i>(8) = 4.232, <i>p</i> = .002; decreased systolic blood pressure, <i>t</i>(8) = 2.90, <i>p</i> = .010, and diastolic blood pressure, <i>t</i>(8) = 3.21, <i>p</i> = .007; and increased self-management skills as evidenced by DSMQ-R, <i>t</i>(8) = -5.498, <i>p</i> < .001. <b>Conclusions:</b> This QI project highlights multiple interventions for improving diabetes management in a primary care facility. <b>Implications for Nursing:</b> 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.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Doctoral Nursing Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1891/JDNP-2023-0060","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
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.