Date of Degree

12-2022

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Holly A. DiLeo

Abstract

Background: Diabetes mellitus is a chronic medical condition that affects more than 34 million Americans (Centers for Disease Control and Prevention, 2020). The financial impact of diabetes is significant. Americans spend $327 billion on direct medical costs to treat the disease and its associated complications (American Diabetes Association, 2018). The management of diabetes requires a multidisciplinary approach that involves healthcare providers, diabetes self-management support resources, and a high level of commitment from the patient. Patients with diabetes discharged from the hospital often receive fragmented and inconsistent information about managing their health issues. As they transition from hospital to home, their care is often inefficient and lacks proper coordination. Many patients simply fail to follow up with a primary care provider.

Purpose and Objectives: The purpose of this project was to introduce continuous glucose monitoring during a patient’s transition from hospital to home, thereby improving diabetes self-management. The objectives were to educate patients on adapting their diet and lifestyle in response to real-time glucose readings and to enable healthcare providers to adjust treatment based on trends retrospectively. A long-term goal was to reduce the financial burden of type 2 diabetes by decreasing re-admissions.

Interventions & Evaluation: Patients received comprehensive diabetic education and continuous glucose monitoring devices. Follow-up appointments were made for patients before discharge, and the follow-up communication was conducted with each patient. Each intervention was measured on its effectiveness.

Outcomes: Results were as follows: (N=46)

  • Continuous glucose monitoring increased from 0 to 70%
  • 100% of patients who were provided a continuous glucose monitor received diabetic education and support on diabetes management
  • 100% of patients who received a continuous glucose monitor reported awareness of glycemic trends
  • 50% of patients were scheduled for a follow-up appointment upon discharge
  • No patients were readmitted within 30 days for diabetes-related complications

Implications for Practice: Nurse Practitioners are at the forefront of providing clinical advances that improve the patient’s well-being. By utilizing continuous glucose monitoring in primary care settings, Nurse Practitioners can reduce the incidence of hospitalizations by effectively treating patients with type 2 diabetes.

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