Date of Degree

12-2022

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Maureen Rauschhuber

Abstract

Background. Patients greatly benefit from diabetes self-management education (DSME) as it boosts knowledge and self-efficacy, decreases body weight, fasting blood sugar, and hemoglobin A1C levels, and improves overall health outcomes in a cost-effective manner. Unfortunately, many individuals with prediabetes and diabetes who qualify for DSMEs do not attend these classes nor receive sufficient prediabetes and diabetes support elsewhere to attain guideline recommended metrics. However, individuals from vulnerable populations and without DSME education experience disproportionate diabetes-related complications worsening health outcomes. Aims: Increase general prediabetes and diabetes knowledge, facilitate behavior change, improve glycemic, metabolic, and lipid values, and increase healthy dietary planning and physical activity among patients with prediabetes and diabetes. Purpose. Provide an interdisciplinary team DSME education program to patients at a tuberculosis hospital with diabetes and prediabetes in order to empower patients in self-management knowledge and skills in order to prevent or delay complications. Objectives. Review American Diabetes Association (ADA) medical care guidelines with providers, monitor changes to ordered dietary and medication regimens based on laboratory values as per guideline recommendations, reduce individual glycemic, metabolic, and lipid laboratory markers, improve patients’ verbalization of guideline-supported dietary and exercise recommendations, increase patient recognition of signs and symptoms of dysglycemia along with its management, and increase aerobic and resistance exercise participation. Interventions. Provide a closed-caption television (CCTV) prediabetes and diabetes educational programming, conduct weekly DSME classes, initiate a walking and yoga exercise program, encourage online educational module learning, and reinforce class and CCTV interventions with prediabetes and diabetes infographic handouts. Evaluation. Monitor the electronic health record for orders, laboratory results, and staff documentation of education and participation along with the use of patient surveys to assess changes in knowledge, motivation, and self-efficacy. Practice Implications. Many studies have researched the effectiveness of DSMEs in many settings, but none have studied the application of this intervention in a long-term care setting among individuals from vulnerable populations who are experiencing an acute bout of illness. The findings from this quality improvement project will help establish the efficacy of implementing prediabetes and diabetes education programs in hospitals as this presents an opportune time to educate patients.

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