Defense Date
4-16-2024
Graduation Date
Spring 5-11-2024
Submission Type
Dissertation/Thesis
Degree Name
Doctor of Nursing Practice (DNP)
Department
Doctor of Nursing Practice (DNP) Program
School
School of Nursing
Faculty Mentor
Mary Loughran
Keywords
Diabetes type 2, adult, rural, barriers
Abstract
Diabetes is a significant healthcare issue that not only effects the United States but also has a global impact, it is costly for the workforce and to manage. Diabetes management is more complex in rural areas due to increased SDOH and barriers to care. The purpose of this quality improvement (QI) project is to identify and overcome the barriers to care from the patients and nurse practitioners’ (NPs) perspectives in adult patients with type 2 diabetes mellitus (T2DM) in a rural federal qualified health clinic (FQHC). A mixed method approach was used including qualitative and quantitative data project manager created provider questionnaire, Diabetes Self-Assessment Questionnaire (DSQ), and analyzing fasting glucose and A1C. A 10% increase in confidence and knowledge level of managing T2DM and identifying and managing social determinants of health (SDOH) was achieved by 67% of the NPs. Fifty percent of the patients reaching a fasting glucose between 80-130 and A1C below 7%, while 75% of the patients experienced weight loss during the 3-month project period. Seventy-five percent of the patients received resource information based on the DSQ interview. The provider data showed that the educational round table session addressed the providers knowledge gaps and confidence in managing T2DM and understanding and identifying SDOH. Patient centered interventions and customized care plans benefited these rural patients with improvements in glycemic control, A1C, weight, SDOH, and improved communication between the patients and providers. A gap in research on the management of T2DM in the rural setting was identified.
Keywords: Diabetes type 2, adult, rural, barriers
Language
English
Recommended Citation
Miscovich, Jill, "Identify and Overcome the Barriers of Care from a Patient and Provider Perspective in Adult Patients with Type 2 Diabetes Mellitus in a Federal Qualified Health Clinic: A Quality Improvement Project" (2024). Doctor of Nursing Practice (DNP) Manuscripts. 50.
https://dsc.duq.edu/dnp/50