Date of Award
Evidence-Based Project Report
Doctor of Nursing Practice (DNP)
As the seventh leading cause of death, diabetes affects more than 25 million Americans and contributes to major cardiovascular diseases and complications (CDC, 2011). The cost of care for these Americans is astounding: $174 billion dollars was spent on diabetes care in 2007 (ADA, 2011). Furthermore, an estimated 75% of patients with type 2 diabetes have concomitant hypertension, and nearly one-half of these patients have uncontrolled hypertension (Thomas & Kodack, 2011; USDHHS, 2011). An initial chart audit at an outpatient, rural clinic in east central Illinois revealed that 90% of the type 2 diabetic population had concomitant hypertension, and only 57% of these patients had controlled blood pressure (< 130/80 mmHg). The purpose of this EBP project was to determine the effectiveness of provider audit and feedback for improving blood pressure control in the type 2 diabetic population. Rogers’ Diffusion of Innovation and the Promoting Action on Research Implementation in Health Services (PARIHS) framework were used to guide this EBP project. Six providers received individual 20-minute verbal feedback in September 2011 regarding chart audit results of blood pressure control in their diabetic patients. The session detailed benchmarks and included strategies for achieving these benchmarks within the next four months. After four months, a repeat chart audit of the 134 diabetic patients was obtained. Chi-square analysis and frequencies were used to compared the percentage of the patients (mean age = 62.99 years; 48.1% male) who achieved blood pressure control pre and post intervention. Overall, an additional 24 clinic patients achieved systolic control (17.9%) and 17 patients achieved diastolic control (12.7%) following the intervention. However, statistical analyses revealed that the changes within systolic blood pressure control (X = 15, p = 0.088) and diastolic blood pressure control (X = 14.61, p = 0.024) within the clinic and among individual providers were not statistically significant.
Painton, Kara, "The Use of Provider Audit and Feedback on Improving Hypertension Control in the Type 2 Diabetic Population" (2012). Evidence-Based Practice Project Reports. 13.