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Date of Award

12-8-2021

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

Thesis Committee Chairperson

Janice Hobba-Glose, DNS, MSN, RN

Second Reader

Jessica D’Alessandro, MSN, RN, AGNP-C

Keywords

type two diabetes mellitus, hemoglobin A1C, A1C, diabetes self-management, educational program, telehealth

Abstract

Clinical Problem: Glycemic control or management of hemoglobin A1C in patients diagnosed with type two diabetes mellitus is a major health concern worldwide. Approximately 463 million adults were diagnosed with diabetes in 2019 (Eberle et al., 2021). Of those diagnosed with diabetes, type two diabetes accounts for about 95% of cases (Eberle et al., 2021).

Significance: The burden of uncontrolled type two diabetes is vast. Those with uncontrolled type two diabetes are at an increased risk of developing secondary health complications such as a heart attack, stroke, neuropathy, retinopathy, and kidney failure (WHO, 2018). Uncontrolled diabetes is also of concern due to its economic burden on national health care systems (Kumah et al., 2018). An estimated 327 billion dollars are spent each year for the treatment of diabetes (Kumah et al., 2018). Management of A1C, increased knowledge, and greater satisfaction through a diabetic self-management education program in combination with telehealth contributes to better outcomes in type two diabetics.

PICOT Question: This evidence-based proposal looks to answer the question “Among type two diabetic patients, what is the impact of diabetes self-management education programs and telehealth on knowledge, patient satisfaction, and A1C over six months”.

Clinical Change: The proposed clinical change is that patients diagnosed with type two diabetes that complete a six-month diabetes self-management program in combination with telehealth will have decreased A1C levels, have greater knowledge on the disease, and have increased satisfaction.

Desired Outcome: The desired outcome for the implementation of the proposed clinical change is to increase patient knowledge on the disease, increase patient satisfaction, and to reduce A1C levels in type two diabetics to help prevent further diabetes-related complications.

Summary: After a thorough review of the literature, it was evident that glycemic control is essential in patients diagnosed with type two diabetes. This evidence-based proposal demonstrates a plan for implementation of a diabetes self-management educational program and telehealth, specifically a mobile app, which can be used to help patients control their hemoglobin A1C levels. Ultimately, helping to reduce further complications from diabetes such as heart disease, damage to the eyes, kidneys, and nerves.

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