Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Rose M. Flinchum


Diabetes self-management education and support (DSMES) programs have been shown to improve patient outcomes and lower hemoglobin A1c (Hgb A1c) levels in those who are diagnosed with type two diabetes mellitus (T2DM). However, these programs are often underutilized and have low referral rates, despite the known benefits (Powers et al., 2020). The purpose of this patient-centered EBP project was to evaluate the effectiveness of a patient-driven questionnaire, completed by patients with T2DM during routine office visits, in increasing the percentage of patients referred to DSMES by their provider. Specifically, this project addressed the following PICOT question: In adults who have T2DM (P), how does the implementation of a screening tool (I) compared to current practice (C) impact the number of patient referrals to the DSMES (O) over a 12-week period (T)? This EBP project took place at an internal medicine clinic in northern Indiana. There are two providers at this clinic and four medical assistants (MA). After eligibility was determined, the patient was given the screening tool for completion. Any “yes” or concerning answer triggered the provider to submit the DSMES referral. A total of 54 screening tools were administered and 22 patients were referred to the program. Data between groups were analyzed using odds ratio. It was found that patients seen during the time period in which the screening tool was used were 2.3 times as likely to be referred than those during the same period in the previous year (p =.039), 95% CI [1.07, 5.37]. These findings indicate that a patient-driven screening tool streamlines the referral process to the DMSES and assists in provider understanding of when the patient with T2DM requires referral.

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Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
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A. Milcarek DNP poster.pdf (119 kB)