Assessment of adherence to American Diabetes Association guidelines and evaluation of social determinants of health and interventions in patients with type 2 diabetes mellitus in a nurse practitioner-owned clinic.
Rachel G Murumba, Rachel O Naman, Christine A Tuohy, Patricia A White, Wendy Wright
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引用次数: 0
Abstract
Background: This was an ongoing quality-improvement (QI) project that aimed to assess the quality of nurse practitioner (NP)-driven diabetes care based on the 2023 American Diabetes Association (ADA) Standards of Care (SOC) at a NP-owned primary care practice. In addition, a more recent focus was the assessment of and intervention on social determinants of health (SDOH). Nationally, 47.4% of people with diabetes mellitus (DM) have an HbA1C of >7.0%. Adherence to ADA SOC for DM management minimizes the risk of diabetes-associated complications.
Local problem: At a NP-owned clinic, within one year, the average A1Cs improved in all patients except those with positive SDOH despite receiving similar care. SDOH predicts DM prevalence and severity of progression, yet screening is not consistently performed or documented.
Methods: An ongoing retrospective chart review since 2013 has assessed adherence to ADA SOC among adult patients with type 2 DM at an NP-owned practice. Multiple Plan-Do-Study-Act (PDSA) cycles have resulted in new recommendations that have promoted adherence to diabetes metrics and improvement in overall mean A1C.
Interventions: The current PDSA cycle emphasizes the creation and implementation of evidence-based interventions to assist NPs in addressing social needs at a NP-owned practice.
Results: Recent data collection has included frequency of SDOH screening, identifying social needs, gaps in SDOH documentation, and has found overall higher A1Cs in patients with positive screens.
Conclusions: Project intervention of social workers collaboration with NPs resulted in improvement in addressing social needs in patients with type 2 diabetes mellitus.
期刊介绍：
The Journal of the American Association of Nurse Practitioners (JAANP) is a monthly peer-reviewed professional journal that serves as the official publication of the American Association of Nurse Practitioners.
Published since 1989, the JAANP provides a strong clinical focus with articles related to primary, secondary, and tertiary care, nurse practitioner education, health policy, ethics and ethical issues, and health care delivery. The journal publishes original research, integrative/comprehensive reviews, case studies, a variety of topics in clinical practice, and theory-based articles related to patient and professional education. Although the majority of nurse practitioners function in primary care, there is an increasing focus on the provision of care across all types of systems from acute to long-term care settings.
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