ABSTRACT Background: Diabetes has become an epidemic in the United States, affecting nearly 30 million people per year (National Center for Chronic Disease Prevention and Health Promotion [NCCDPHP], 2014). Type 2 Diabetes Mellitus (T2DM) disproportionately affects Hispanics. The American Diabetes Association (ADA) has established diabetes care guidelines that focus on improving diabetes care and patient outcomes. Quality improvement (QI) efforts have been developed and proven effective at targeting specific diabetes care indicators. Problem: Wesley Health Center (WHC) has identified deficiencies in select ADA diabetes quality care indicators of ophthalmologist referral, annual foot exam, smoking cessation counseling and pneumococcal vaccines for all patients with T2DM (ADA,2015). Design: A QI project applying the Plan-Do-Study-Act (PDSA) cycle was implemented to improve the select diabetes quality care indicators of ophthalmologist referral, annual foot exam, smoking cessation counseling and pneumococcal vaccines for all patients with T2DM. Setting: WHC, a community health center located in Phoenix, Arizona, services mostly uninsured and underinsured Hispanic patients. Intervention: One PDSA cycle was carried out utilizing the fishbone diagram in an effort to identify root cause of the stated problem. The team of stakeholders identified modifications of the current electronic adult template as a key contributing factor. Workflow process changes that complemented the new modifications to the template were also made. The intervention was carried out for six (6) weeks with weekly stakeholder meetings. Expected Outcome: To improve select ADA diabetes quality care indicators for adult patients with T2DM within six (6) weeks of implementation by at least 10% from baseline. Results: Errors in data querying parameters limited data accuracy and interpretation thus the impact of the intervention was not able to be evaluated. Significance: QI interventions are important to nursing practice because they emphasize the importance of a doctorally prepared Advanced Practice Nurse (APRN) to be able to identify a problem in clinical practice and carry out a QI intervention in an effort to improve patient care and outcomes. A QI intervention provides the DNP prepared APRN an opportunity to synthesize into one project the skills and knowledge learned throughout their DNP program.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/621749 |
| Date | January 2016 |
| Creators | Davila, Claudia Jazmin, Davila, Claudia Jazmin |
| Contributors | McEwen, Marylyn M., McEwen, Marylyn M., Carrington, Jane M., McArthur, Donna B. |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | text, Electronic Dissertation |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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