Exploring the Clinical Outcomes of Implementing Diabetes Self-Management Education and Support in a Primary Care Practice: A Quality Improvement Project.

IF 0.2 Q4 NURSING
Candace Lee McGowen, Susan J Appel
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Abstract

Introduction/Purpose: Diabetes self-management education and support (DSMES) can be a very valuable service for many patients with diabetes. Unfortunately, despite its expected benefits, many patients do not receive DSMES through a quality, structured program. The purpose of this quality improvement project was to determine if integrating a diabetes education program utilizing the Association of Diabetes Care and Education Specialists (ADCES)7 Self-Care Behaviors into diabetes care in a primary care clinic could improve glycemic control and body mass index (BMI). Methods: The DSMES services provided were in accordance with the ADCES and the American Diabetes Association National Standards. The program included a 1-hour face-to-face service incorporating the ADCES7 Self-Care behaviors. A retrospective chart review was conducted to extract outcome data from N = 54 random medical records. This data was then analyzed to evaluate the program's effectiveness. Pre- and postintervention data from medical records were analyzed for eligible patients who participated in the DSMES service (ages 18-75 with type 2 diabetes, hemoglobin A1c [A1c] >8%). Results: Paired t tests were used to determine significant changes in BMI and A1c parameters pre- and postintervention. Preintervention A1c (M = 9.5, SD = 1.7) and BMI (M = 33.2, SD = 7.8) and postintervention A1c (M = 7.8, SD = 1.5) and BMI (M = 32.2, SD = 7.9) indicate that DSMES significantly reduced A1c, t(53) = 8.1, p = <.001, and BMI, t(53) = 4.4, p = <.001. Models were then adjusted for pretest measures, age, gender, and time since diagnosis in a regression analysis. In models adjusted for pretest measures, age, gender, and time since diagnosis was significantly predictive of the postmeasure of BMI (B = .41, p = .01, R2 = .96) and postmeasure of A1c (B = .28, p = .04, R2 =.41). Discussion: This project demonstrated that integrating a simple, cost-effective diabetes education service consisting of ADCES7 Self-Care Behaviors in a primary care practice could bridge gaps in diabetes management and significantly improve patients' BMI and A1c. Long-term utilization of this service may also enhance patient satisfaction, improve the patient's health, and reduce healthcare costs related to diabetes.

探索在初级保健实践中实施糖尿病自我管理教育和支持的临床效果:一个质量改进项目。
前言/目的:糖尿病自我管理教育与支持(DSMES)对许多糖尿病患者来说是一项非常有价值的服务。不幸的是,尽管有预期的好处,许多患者并没有通过高质量的、结构化的计划接受DSMES。本质量改进项目的目的是确定在初级保健诊所的糖尿病护理中整合糖尿病教育计划,利用糖尿病护理和教育专家协会(ADCES)的7种自我护理行为,是否可以改善血糖控制和体重指数(BMI)。方法:按照ADCES和美国糖尿病协会国家标准提供DSMES服务。该计划包括一个1小时的面对面服务,包括ADCES7自我护理行为。回顾性图表分析从N = 54份随机病历中提取结果数据。然后对这些数据进行分析,以评估该计划的有效性。对参与DSMES服务的符合条件的患者(年龄18-75岁,2型糖尿病,血红蛋白A1c >8%)的医疗记录进行干预前和干预后数据分析。结果:采用配对t检验确定干预前后BMI和A1c参数的显著变化。干预前A1c (M = 9.5, SD = 1.7)和BMI (M = 33.2, SD = 7.8)以及干预后A1c (M = 7.8, SD = 1.5)和BMI (M = 32.2, SD = 7.9)均表明,DSMES显著降低了A1c (t(53) = 8.1, p = t(53) = 4.4, p = B = 0.41, p = 0.01, R2 = 0.96)和干预后A1c (B = 0.28, p = 0.04, R2 = 0.41)。讨论:该项目表明,在初级保健实践中整合由ADCES7自我保健行为组成的简单,具有成本效益的糖尿病教育服务可以弥补糖尿病管理方面的差距,并显着改善患者的BMI和A1c。长期使用该服务还可以提高患者满意度,改善患者健康状况,并降低与糖尿病相关的医疗保健费用。
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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