Abstract

Background: Diabetes diagnosis rates continue to grow, affecting many patients, communities, and health care organizations. One of the greatest challenges faced by patients with diabetes is maintaining diabetes self-management activities including self-blood glucose monitoring, physical activity, a healthy diet, and daily foot checks in order to control their diabetes and reduce their A1c. Diabetic Medical Concepts (DMC) previously provided intermittent and inconsistent in-home diabetes self-management education. An in-home diabetes self-management education program, adherence system and A1c testing component was implemented among DMC's patients as part of a quality improvement project.

Aim: The aim of the quality improvement project was to provide in-home diabetes selfmanagement education and A1c testing to determine if these education sessions had an impact on patient's diabetes self-management adherence and A1c levels.

Methods: The education was provided in the patient's home by DMC home health care nurses once a month for 3 months. The education session included discussion of the American Association of Diabetes Educators (AADE7) handouts and following the in-home education checklist provided to each nurse. Patient adherence to the diabetes self-management education was measured by the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. A1c
testing was performed in the home by point-of-care testing provided by the nurses.

Results: The results revealed improvement in overall adherence to SDSCA activities (SBGM, physical activity, a healthy diet, and daily foot checks). The difference between the pre- and postcompliance mean scores of 23.24 points (median 23.50) was statistically significant (p <0.0001), significance level of 5%. The pre-intervention SDSCA mean was 34.3 (SD = 7.74) and the postintervention SDSCA mean was 57.54 (SD = 8.39). The mean difference between the A1c preand post-implementation was 0.03 points (median 0) and this was not statistically significant (p = 0.11), significance level of 5%. This result indicated that in-home diabetes self-management education had no significant improvement on the participant's A1c levels. The pre-intervention A1c mean was 8.14 (SD = 0.92) and the post-intervention A1c mean was 8.11 (SD = 8.11).

Conclusion: Incorporating in-home diabetes self-management education increases patient adherence to diabetes self-management and may potentially reduce A1c levels with further duration.

Garrett Blaker

Author Details

Garrett Blaker, DNP, APRN, FNP-C, I obtained my BSN in 2016 at Jacksonville University and DNP in 2020 at Jacksonville University. I am a board certified Family Nurse Practitioner, currently employed at Greater Philadelphia Health Action, Philadelphia, Pennsylvania, USA.

Sigma Membership

Lambda Rho at-Large

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Quantitative Research

Keywords:

Diabetes Self-Management, Glucose Testing Adherence, Self-Monitoring of Blood Glucose, Patient Diabetes Education, Diabetes Physical Activity, A1C Diabetic Diet, A1c Diabetic Diet

Advisors

Kott, Kathryn

Advisor

Kathryn Kott

Degree

DNP

Degree Grantor

Jacksonville University

Degree Year

2020

Rights Holder

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Review Type

Faculty Approved: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2021-12-13

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