Date of Award

Spring 5-11-2022

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Pedro Colio DNP, MSN

Second Advisor

Julio Martinez, MD

Third Advisor

Paloma Camacho, MSN/FNP-C

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a global problem. Lack of healthcare access affects the low-income population and telehealth can aid the problem. For newly-diagnosed T2DM patients, customary practice is a 3-month follow-up after they are diagnosed. Patients only have education on diet and medication given by the healthcare provider at the time of appointment. Patients can be overwhelmed and confused to grasp the information. Telehealth has become mainstream due to the current COVID-19 pandemic and that is why it is the right time to use it to help T2DM patients further. Purpose of Project: The project's goal is to help patients with prediabetes and T2DM decrease the hemoglobin A1C and, by doing this, decrease the disease's complications with an early understanding treatment and by having a provider answer their questions in a telemedicine appointment 2 weeks following diagnosis. EBP Model/ Frameworks: The patients were newly diagnosed as prediabetic or were new patients coming to the clinic diagnosed with T2DM to start treatment. It is a retrospective and prospective project. The model selected for this project is the Advancing Research and Clinical Practice Through Close Collaboration (ARCC) model. Evidenced-Based Interventions: The evidence shows patients have higher satisfaction when they have access to a provider, including remote access. Newly diagnosed T2DM patients need repeated and reinforced education. Early teaching and medication adherence improves Ha1C levels and prevents T2DM complications. Evaluation/Results: A total of 20 patients' post intervention; the intervention showed an average - 0.1 to +1 point in Ha1c when comparing initial level versus 3 months follow-up. The reduction was higher in patients who had a new diagnosis and less in patients diagnosed in the past and had not been taking any treatment. Implications for Practice: Early intervention with patients diagnosed with T2DM can help lower their HgA1c numbers from early in the disease. Healthcare needs to adapt to patients' needs with a lack of access and resources to provide better care. The successful implementation of this project will prevent disease complications and hospitalizations. Conclusions: Telemedicine is an option that can help the patient have access to a provider. Many patients find a diabetes diagnosis shocking and scary. Having open communication with a healthcare provider can help them conquer the fear and start being proactive in their own care. T2DM is a prevalent topic and it is imperative to find the best evidence-based practice to help decrease the number of patients with complications from this disease.

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