Wright Wendy L, Bachmann Jade P, Murphy Nicole, Gifford Lauren, Strowman Shelley, White Patricia
Wright & Associates Family Healthcare, Amherst, New Hampshire.
Department of Nursing, Simmons College, Boston, Massachusetts.
J Am Assoc Nurse Pract. 2019 Jul;31(7):413-419. doi: 10.1097/JXX.0000000000000195.
Diabetes is a major health concern in the U.S. with increasing prevalence. There are limited data on nurse practitioner (NP) roles in diabetes management and clinical patient outcomes in relation to national standards of care. This project aimed to identify rates of American Diabetes Association (ADA) guideline adherence of two NP-owned and operated practices during an ongoing four-year quality improvement project.
Methods: Electronic health records of 83 - 112 patients (depending on the year) ages > 18 years with type 2 diabetes were reviewed. Mean A1C and rates of adherence to ADA standards were compared from 2013 to 2017 and to national and state data.
Findings demonstrated that diabetes management provided by NPs consistently adhered to national ADA standards of care and met or exceeded national data. This four-year ongoing quality improvement project has led to the implementation of practice modifications that continue to improve patient outcomes through increased adherence to ADA guidelines.
Strategies which improve adherence to ADA standards of care by NPs are essential. Identifying rates of adherence and implementing quality improvement strategies can significantly improve the quality of care provided to patients with diabetes.
糖尿病是美国一个日益受到关注的主要健康问题，其患病率不断上升。关于执业护士（NP）在糖尿病管理中的作用以及与国家标准护理相关的临床患者结局的数据有限。该项目旨在确定在一个正在进行的为期四年的质量改进项目中，两家由执业护士拥有和运营的诊所对美国糖尿病协会（ADA）指南的遵循率。
回顾了83 - 112名年龄大于18岁的2型糖尿病患者（取决于年份）的电子健康记录。比较了2013年至2017年的平均糖化血红蛋白（A1C）以及对ADA标准的遵循率，并与国家和州的数据进行了比较。
研究结果表明，执业护士提供的糖尿病管理始终遵循国家ADA护理标准，达到或超过了国家数据。这个正在进行的为期四年的质量改进项目导致了实践改进的实施，通过增加对ADA指南的遵循继续改善患者结局。
提高执业护士对ADA护理标准遵循率的策略至关重要。确定遵循率并实施质量改进策略可以显著提高为糖尿病患者提供的护理质量。
