CAPSTONE COLLEGE OF NURSING THE UNIVERSITY OF ALABAMA Improving Participation of Diabetics in...
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CAPSTONE COLLEGE OF NURSING
THE UNIVERSITY OF ALABAMA
Improving Participation ofDiabetics in Self-
management Education
Letrell Peoples, RN, MSNDr. Roy Ann Sherrod, DSN, RN, CNE, CNL Faculty
AdvisorCapstone College of Nursing - The University of Alabama
Mrs. Debrah Fisher, MSN, RN, CDE Clinical AdvisorManager, DCH Diabetes Education Center
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STUDY OBJECTIVE
To identify factors to increase the participation of patients with diabetes at a regional medical facility in self-management education classes provided by the facility’s outpatient Diabetes Education Center.
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BACKGROUND
Diabetes affects 8.3% of population Direct and indirect care cost for
diabetes averages $174 million per year
Medical expense for people with diabetes is more than 2X higher than those without diabetes (CDC, 2011)
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DM STATISTICS
Alabama has a 12% prevalence rate Tuscaloosa County has 12% prevalence
rate 2012 medical center admissions:30% had primary or secondary DX20% readmissions had primary or
secondary DX
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OPPORTUNITY
1% of inpatients from medical center with diagnosis of DM attended classes at facility’s
DIABETES EDUCATION CENTER (2012)
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WHY EDUCATE?
Diabetes Self-Management Education (DSME) improves knowledge, constructive self-care behaviors, and better clinical outcomes for people with diabetes (Norris, Lau, Smith, Schmid, & Engelgau, 2003) .
Patients who have not received DSME :Lack the skills to effectively care for themselves Have a fourfold increased risk of major diabetes
complications than those who do receive DSME Niccoluci et al. (as cited in Clark, 2008) .
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SAMPLE
Inpatients between the ages of 25-75 Primary or secondary diagnosis of
diabetes Able to participate in educational
offerings Able to comprehend and read the
English language
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DATA COLLECTION
Patient Education Survey Demographic Data Collection Form
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Sample
DemographicsGender: Males (37%) Females (63%)
Race: Black (63.2%) White (35.5%)
DemographicsAge: 55-64 (42.1%)
Education Level: HS or GED (40.8%)
Employment: 25% employed
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Survey Results
Years with Diabetes:
<1 yr-10yrs: 59%
How are you managing:
Moderately well-56.6%
Will learning help: Yes: 89.5%
Importance of learning:
Very or extremely important-92.2%
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Survey Results
Know about Ed. Center:
N0: 63.2%
Would you attend classes
Yes: 80.3%
Did staff ask about attending classes at
Education Center: No: 82.9%
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Factors that would keep you from attending classes at the Diabetes Education Center
Transp
ortation
No Insu
rance
Unable to
Pay
Family
Issues
Limite
d Time
Info from else
whereOth
er0%
10%20%30%40%50%60%70%80%90%
100%
YesNo
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Conclusions
Major Issues Identified:
Transportation – 40%
Inability to pay-out-of-pocket – 30%
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Possible Solutions
Increased marketing of Center To staff and providers To patients
Foundation support Offering scholarships
FundraisersApply for grants
Waiving payment (why?)
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Limitations/Implications
LimitationsSample sizeNo data from
healthcare staff
ImplicationsEBP champion
(Inpatient Diabetes Educator)
Longitudinal studiesIdentify
effectiveness of 2013 ADA Standards
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Acknowledgments
Dr. Roy Ann Sherrod, DSN, RN, CNE, CNL
Mrs. Debrah Fisher, RN, MSN, CDE Mrs. Lorraine Yehlen, RN, BSN, MA Mrs. Shelia Bresnahan, RN, MSN Unit RNs and staff
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REFERENCES American Diabetes Association. (2013). Third-party
reimbursement for diabetes care, self-management education, and supplies. Diabetes Care, 36 (1), 598-599. doi: 10-2337/dc13-S098
American Diabetes Association. (2013). Standards of medical care in diabetes-2013. Diabetes Care, 36, S11-66. Retrieved from http://search.proquest.com/docview/1267207263?accountid=14472
Balamurugan, A, Ohsfeldt, R., Hughes, T, & Phillips, M. (2006). Diabetes self-management education program for Medicaid recipients: A continuous quality improvement process. Diabetes Educator, 32, 893–900.
Clark, M. (2008). Diabetes self-management education: A review of published studies. Primary Care Diabetes, 2, 113–120.
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REFERENCES Fitzner, K., Greenwood, D., Payne, H., Thomson, J., Vukovljak, L.,
McCulloch, A., & Specker, J. E. (2008). An assessment of patient education and self-management in diabetes disease management—Two case studies. Population Health Management, 11(6), 329-340. doi: 10.1089/pop.2008.0012
Gucciardi, E., DeMelo, M., Offenheim, A., Grace, S. L., & Stewart, D. E. (2007). Patient factors associated with attrition from a self-management education programme. Journal of Evaluation in Clinical Practice, 13(6), 913-919. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009721593&site=ehost-live
Gumbs, J. M. (2012). Relationship between diabetes self-management education and self-care behaviors among African American women with Type 2 diabetes. Journal of Cultural Diversity, 19(1), 18-22.
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REFERENCES
Karakurt, P. & Kasikci, M. K. (2012). The effect of education given to patients with type 2 diabetes mellitus on self-care. International Journal of Nursing Practice, 18, 170-179. doi.10.1111/j.1440.172X.2012.02013.x
Norris, S., Lau, J., Smith, S., Schmid, C, & Engelgau, M. (2002). Self-management education for adults with type 2 diabetes: A meta-analysis of the effects on glycémie control. Diabetes Care, 25(7), 1159-1171. doi:10.2337 / diacare.25.7.1159
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2011). National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States.
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