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.

Included in

Nursing Commons