Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Theresa A. Kessler


In 2015, approximately 30.3 million Americans, including 10.5% of the population of Minnesota, had been diagnosed with diabetes mellitus (American Diabetes Association, 2019). Increased risk of diabetic complications including neuropathy, retinopathy, nephropathy, cardiovascular disease, and chronic wounds has been associated with an elevated hemoglobin A1C (HgA1C). Formal diabetic education has been shown to be a cost-effective intervention to reduce HgA1C. The Office of Disease Prevention and Health Promotion published an objective within HealthyPeople 2020 that seeks to increase the percentage of diabetics receiving formal diabetic education in the United States from 46.9% of adults to 58.4%. The purpose of this evidence-based project was to determine if providers managing diabetic patients at a primary care clinic (PCC) in Minnesota were positively impacted by a written policy, point of care reminders, and audit and feedback to increase referral rates to diabetic education, compared with no interventions. The providers at the PCC included physicians (n = 9) and family nurse practitioners (n = 2). Pre-intervention data from the same time period (n = 12 weeks) was gathered from the previous year and compared with post-intervention data collected at 2 weeks, 6 weeks, and 12 weeks. This data was analyzed using a Wilcoxon Signed Rank test. A secondary outcome examined the effectiveness of each phase of interventions including a written protocol (weeks 1-2) ; written protocol with point of care reminders (weeks 3-6); and protocol, point of care reminders, and audit with feedback (weeks 7-12). The secondary outcome was evaluated with a repeat measure ANOVA. The results and how they pertain to current standards of care and patient outcomes are discussed.

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

D. Rokser DNP poster.pdf (165 kB)