Development and Evaluation of a Nurse Practitioner-Directed Intervention to Improve Referrals to Diabetes Self-Management Education in Primary Care

摘要

Type 2 diabetes mellitus (T2DM) is a common preventable disease that is expensive and liable for substantial mortality and morbidity in the United States (Nhim et al., 2018). The National Diabetes Prevention Program (National DPP) has been effective in reducing the risk of disease progression from prediabetes to T2DM (Keck et al., 2020). Despite evidence of the effectiveness of diabetes self-management education (DSME), primary care provider (PCP) referrals remain suboptimal (Nhim et al., 2021). This quality improvement project aimed to examine provider referrals to DSME upon utilization of the Prediabetes Risk Test (see Appendix A). The electronic medical record (EMR) was used to identify rates of referrals to DSME for each PCP to compare pre- and post-intervention data. Patients completed the Prediabetes Risk Test prior to their encounter with the provider in an effort to prompt the provider to write a referral if indicated based on the test score. Pearson chi-square tests were used to analyze data on four providers for the bivariate association between the utilization of a diabetes screening tool and provider referrals to DSME. It was anticipated that the use of the Prediabetes Risk Test would be positively associated with an increase in provider referrals to DSME. This quality improvement project highlights the importance of implementing a diabetes screening tool to increase provider referrals to DSME.