Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Jean Dols


Background:A significant number of individuals with type 2 diabetes mellitus do not receive comprehensive diabetes care management to maintain optimal health.

Purpose:This project was designed to facilitate provider adherence to the type 2 diabetes mellitus evidence-based practice standards of care. A primary care practice needs assessment indicated opportunities to improve care management processes which promote adherence to current clinical practice guidelines.

Methods:This 10-week quality improvement project provided the clinical staff and provider with the necessary tools to implement best practices of diabetes care. Objectives assessed throughout project implementation included the design and use of an electronic health records alert system; clinical staff and provider participation in a diabetes education session; completion of the evidence-based comprehensive diabetes management flowsheet with verification by provider and patient signature; completion of routine laboratory tests such as HgbA1c and annual microalbuminuria; documentation of preventive measures employed such as medications, annual exams, and vaccines; and documentation of diet and exercise counseling.

Results:The use of a diabetes flow sheet resulted in decreased HgA1c results greater than 7.0% with more than half of the patients with type 2 diabetes mellitus having a prescribed preventive medication, and all patients with a completed flowsheet received diet and exercise education.

Implications for Practice:Incorporating current diabetesstandards in the management of patients with type 2 diabetes can prevent disease-related complications and improve health outcomes.