Date of Degree

12-2021

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Holly DiLeo

Advisor

Nichole Van De Putte

Abstract

Within the last 10 years, the number of pregnant women with gestational diabetes increased 56%, and the number of women with Type 1 or Type 2 diabetes before pregnancy increased 37% (CDC, 2018). The management of a pregnancy complicated by diabetes involves a multidisciplinary approach, medical nutrition therapy, glycemic control, and occasionally, pharmacological therapies (Nurain et al., 2019). In 2017, the total cost of diabetes in the United States was $237 billion (Riddle & Herman, 2018). The purpose of this DNP project was to standardize a Federally Qualified Health Care’s (FQHC) High-Risk Obstetrical (OB) Initiative, which attempted to provide in-person education and monitoring by an RN in addition to regular OB visits. The project used a multidisciplinary approach to expand on the initiative by (a) instituting a standardized enrollment process, (b) implementing an electronic health record (EHR) dashboard to track enrollees, (c) gathering evidence-based patient education materials, (d) introducing a Social Determinants of Health (SDoH) assessment, (e) determining the follow-up interval for RN monitoring, and (f) developing an RN documentation template. This project focused on mothers at risk of diabetic complications during pregnancy. The results showed enrollment in the initiative increased from seven expecting mothers pre-implementation to 57 expecting mothers post-implementation, thereby increasing the knowledge and monitoring of diabetic mothers. Creating a standardized multidisciplinary process with weekly follow-up by a Registered Nurse (RN) can help pregnant diabetic women identify signs and symptoms of maternal/fetal distress due to diabetic complications, resulting in the prevention of severe complications, improved pregnancy outcomes, and decreased costs.

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