Date of Award
Evidence-Based Project Report
Doctor of Nursing Practice (DNP)
Michael J. Poulsen
Diabetes is a complex, chronic illness, and a leading cause of morbidity and mortality (ODPHP, 2019). Gaps in diabetes care exist between clinical guidelines and interventions provided in the clinical setting (ADA, 2015; Chauhan et al., 2017; Renders et al., 2001; Worswick et al., 2013). Improved diabetes management strategies and interventions among healthcare providers are essential to close the quality gap. The purpose of this evidenced-based practice (EBP) project was to prompt providers to adhere to diabetes care guidelines using a paper point-of-care reminder over a 12-week period. Provider performance rates covering four specific guidelines were measured: HbA1c, microalbuminuria, diabetic foot exam and referral for retinal screen. The Johns Hopkins Nursing Evidence Based Practice (JHNEBP) model (Dang & Dearholt, 2017) was used to guide the project. After careful synthesis of the evidence, a paper point-of-care reminder was determined to be the best method for improving provider adherence to clinical guidelines. The practice change was developed and implemented in two clinics within a Northern Indiana healthcare system. Weekly chart audits were conducted to collect and analyze data to determine the effectiveness of the implementation. Outcomes of the four diabetic measures will be tested for statistical significance utilizing a paired sample Wilcoxon signed-rank test. Recommendations based on the results of the EBP project will be made to the healthcare system. The healthcare system may, then, implement protocols and procedures for a paper point-of-care reminder system to improve provider performance rates and close the quality gap.
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Spohn, Eric E., "Point-of-Care Reminders to Prompt Provider Adherence with Diabetes Care Guidelines for Adults" (2020). Evidence-Based Practice Project Reports. 156.
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