Date of Award

Spring 5-25-2019

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Joseph Burkard, DNSc, CRNA

Second Advisor

Razel B. Milo, PhD, DNP, FNP-C, APRN


Objective: Self-care disease management is a crucial component in achieving healthy glycemic targets among type 2 diabetes mellitus (T2DM) patients to improve health outcome resulting in reduced healthcare cost. The purpose of this evidence-based practice (EBP) project is: 1) to improve hemoglobin glycated (A1C) levels to

Research Design and Methods: The EBP project took place in a private primary clinic in National City, California. A total of eight T2DM respondents with an A1C level of >7% were included to partake in the EBP project. A 30-minute Diabetes Self-Management Education and Support (DSMES) utilizing the designated seven self-care behaviors of the American Association of Diabetes Educators (AADE) and a telephone follow-up; and administration of DSMQ were provided to respondents as interventions. Both A1C levels and DSMQ were obtained at baseline and during follow-up after 3 to 8 months.

Results: Tailored individualized DSMES utilizing various evidence-based interventions

resulted in reduced average A1C levels from 8.8% to 7.5% and increased DSMQ scores from 11.1 to 19.8 after project interventions.

Conclusions: A combination of various self-care management strategies promotes healthy glycemic control in this patient population. DSMES according to individuals’ need and preference increases patient’s engagement to self-care activities related to T2DM. A1C levels within the American Diabetes Association (ADA) recommendation can ultimately increase practice revenue and reduce healthcare cost.

Available for download on Friday, April 23, 2021

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Nursing Commons