Date of Degree

12-2018

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Diana Beckmann-Mendez

Advisor

Jyothi Achi

Abstract

Purpose. To implement an evidence-based hyperlipidemia guideline for statin therapy use with diabetic patients. Background. In the United States, cardiovascular disease (CVD) continues to be the leading cause of mortality and morbidity for women and men with diabetes. Dyslipidemia is a modifiable risk factor for CVD and one of the leading drivers behind the development of coronary artery disease. In 2014, the American Diabetes Association issued a new recommendation guideline for using statins as a primary intervention for CVD in patients aged 40–75 with diabetes. Despite advances in prevention and treatment guidelines, the American College of Cardiology and ADA have identified a substantial gap in hyperlipidemia guideline implementation across clinical settings. Methods. Patients with diabetes were identified and assigned a statin dose based on their risk factors for atherosclerotic CVD. Patients with a history of clinical atherosclerotic CVD were initiated on a high-dose statin therapy, whereas those with no history of CVD were initiated on a moderate-dose statin therapy. Follow-up was conducted at 6 weeks. Outcomes. Out of 122 diabetic patients, 61 (46.5%) were newly started on a statin, 33 (27%) had their statin corrected to the proper dose, 28 (23%) were on the proper statin dose already, and 8 (3.5%) were ineligible for a statin. All patients (100%) taking a statin tolerated their dose and experienced no adverse effects. Implications for Practice. Bridging the gap between research and practice can be successful with careful implementation of a system that can be followed to improve outcomes.

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