Date of Award

Spring 5-21-2016

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Kathy James, DNSc, APRN, FAAN

Second Advisor

Scot Nolan, DNP, CNS, CCRN, CNRN

Third Advisor

Brian Meyerhoff, MD



Purpose: The purpose of this quality improvement project was to implement and evaluate the impact of Diabetes Self-Management Education (DSME) program with type 2 diabetes mellitus (DM) patients. The goals were to improve glycosylated hemoglobin (A1C) and improve patient satisfaction.

Methods: A quality improvement project using the Iowa model was implemented in a primary care setting in Southern California to provide DSME program for adults with type 2 diabetes. A nurse practitioner conducted three DSME group sessions, which were done for 90 minutes per session in a 4-month period. The American Association of Diabetes Educators (AADE) 7 self-care behavior guidelines were used to develop the DSME program. Five patients with type 2 DM participated in the program. Patient satisfaction and A1C levels were collected at baseline and after the completion of the program.

Results: The average AIC for patients at the initiation of DSME was 9%. After the completion of DSME program, the mean reduction in A1C was 1.44%, and the range change was 1% to 1.8 %. Twenty percent of total participants met the objective of decreased A1C level below 7%. Five patients, (100%), had 10% decrease in their A1C levels after completing the program and scored “highly satisfied” with the DSME program.

Conclusion: As the prevalence and incidence of diabetes increase, a coordinated model of care can meet the growing demand for access and utilization of DSME programs. Health care providers in primary care settings can replicate DSME programs focusing on chronic conditions to improve outcomes.