Date of Award

5-5-2015

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Christine P. Kurtz

Abstract

Only one in eight adults with diabetes reaches target goals for disease management, which can lead to clinical complications, costly both economically and in quality and duration of human life. The standard of care is a quarterly 15-minute face-to-face visit-- arguably inadequate to impart self-care knowledge. The purpose of this EBP project was to deliver a 30-day diabetes self-management education program (DSMEP) utilizing widely accessible web-based technology to facilitate adults with diabetes to reach targeted goals. Using the Chronic Care Model as a framework, the DSMEP design was based on an extensive literature review of the delivery of DSMEP in an asynchronous manner via web-enabled devices. The program consisted of two daily short messages of diabetes self-management content with two-way message capability allowing participants to respond or seek clarification. Participants’ (N = 16) pre-DSMEP A1C values were converted to an estimated average glucose (eAG) value using the A1C Average Glucose Study Group formula, which were compared to their 30-day DSMEP mean blood glucose values using a paired t-test. A RM-ANOVA was performed to determine at what point in the DSMEP blood glucose values had the most significant improvement. Participants completed a pre- and post-intervention Diabetes Self- Management Questionnaire (DSMQ), allowing for comparison of self-reported selfmanagement skills using a paired t-test. The pre-intervention eAG was 193.8 (sd = 38.58), and the post-intervention mean glucose value was 151.9 (sd = 28.07) (t = -41.85, p < .001). The pre- and post-intervention DSMQ sum scale and glucose monitoring control subscale results showed statistically significant improvement. Improvements were also noted in dietary management and physical activity behaviors. Results indicate that a DSMEP delivered from a patient portal to a web-enabled device is an effective way to significantly improve the mean daily blood glucose value of the adult with diabetes type 2 and improvement in self-reported diabetes self-management skills.

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