Date of Award

5-7-2014

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Kristen L. Mauk

Abstract

Type II diabetes affects millions of people worldwide. Approximately 25.8 million or 8.3 percent of the United States (U.S.) population has type II diabetes. The number of adults in the United States developing diabetes has been projected to double by the year 2030 (World Health Organization, 2013). Diabetes is the leading cause of kidney failure and blindness, as well as the major cause of heart disease and stroke which is the 7th leading cause of death in the U.S. The purpose of this evidence-based project was to determine the effects of education during shared medical appointments with type II diabetic patients, aged 18-75. Hemoglobin A1C levels were compared from the initial shared medical appointment, when education was provided, to the follow-up shared medical appointment three months later. The Chronic Care Model was utilized to guide this intervention. Referral to this project was from health care providers within a family practice in Marshall County Indiana. Twenty Participants (N = 20) completed the shared medical appointments. The data were analyzed through descriptive statistics, paired sample t-tests and Wilcoxon statistics. Hemoglobin A1C levels were the primary outcome measures. A statistical significant difference was found in hemoglobin A1C (SD = .803, p = .000) between the initial and follow-up measures. Significant additional findings included these changes: (a) body mass index (BMI) (p = .001), (b) systolic blood pressure (p = .484), (c) diastolic blood pressure (p = 0.064), (d) total cholesterol (p = 0.015), and (e) low-density lipoprotein (LDL) (p = .001) as a result of the educational intervention. This evidence-based project had positive outcomes that replicated what has been found in the literature on hemoglobin A1C levels when education was provided during shared medical appointments. The application of findings has been presented to providers in the family practice where the intervention was completed. Shared medical appointments have been adopted by the clinical agency as a valuable asset and program that will be initiated in diabetes care.

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