NURS FPX 9030 Assessment 1 Raw Data Upload

NURS FPX 9030 Assessment 1 Raw Data Upload Student Name Capella University NURS-FPX9030: Doctor of Nursing Practice Across the Lifespan III Professor Name Submission Date Raw Data Upload Diabetes remains one of the greatest chronic diseases that is treated at the primary care level and requires continuous monitoring, planned follow-up, and patient education that is tailored to reduce complications and the burden of the illness. Among the adult diabetic patients within the project site, there is a lack of sufficient glycemic control, as illustrated by 42% of them having HbA1c levels above 9, which points to gaps in the continuity of care, the delivery of health education, and adherence to follow-up. The quality improvement project is informed by the PICOT question below: How can the implementation of the ADA diabetes follow-up protocol (I), compared to the existing practice (C) can influence the glycemic control (O) in 12 weeks (T), in a state of diabetes care in adults (P)? This project team suggests the possibility of adopting an evidence-based follow-up protocol to enhance the competency of the staff and, eventually, to enhance glycemic outcomes, hence proving the value of structured, collaborative, and sustainable practices with diabetes care. The assessment below relates to a set of raw data, which was gathered in the process of a 12-week quality improvement (QI) project aimed at enhancing glycemic control among adult patients with type 2 diabetes (T2DM) in an outpatient primary care setting. The project team used the American Diabetes Association (ADA) suggested diabetes follow-up protocol and evaluated the effect on patient glycemic outcomes, staff clinical competency, patient follow-up compliance, and self-management behaviors. The data below are de-identified. The names of patients were substituted with the ID of the participants (P001-P020). Staff IDs (S001–S008) were used in place of staff names. No personally identifiable information (PII). The information was obtained by the electronic health record (EHR) system and competence assessment tools used by the clinic during the implementation. Table 1 Patient Demographic Characteristics and Baseline HbA1c (N = 20) Participant ID Age Group Sex Race/Ethnicity Insurance Type T2DM Duration (yrs) Baseline HbA1c (%) P001 45–54 Female Hispanic/Latino Medicaid 6 9.8 P002 55–64 Male Black/African American Medicare 11 10.2 P003 35–44 Female White/Non-Hispanic Private 3 8.7 P004 55–64 Female Hispanic/Latino Medicaid 9 11.1 P005 45–54 Male Asian Medicaid 5 9.4 P006 65+ Male Black/African American Medicare 14 10.8 P007 35–44 Female White/Non-Hispanic Private 2 8.3 P008 55–64 Male Hispanic/Latino Medicaid 8 9.9 P009 45–54 Female Asian Private 4 8.9 P010 65+ Female Black/African American Medicare 16 11.4 P011 35–44 Male White/Non-Hispanic Private 3 8.5 P012 55–64 Female Hispanic/Latino Medicaid 10 10.6 P013 45–54 Male Black/African American Medicaid 7 9.7 P014 65+ Female Hispanic/Latino Medicare 13 10.9 P015 35–44 Male Asian Private 2 8.2 P016 55–64 Female White/Non-Hispanic Private 9 9.3 P017 45–54 Male Hispanic/Latino Medicaid 6 10.1 P018 65+ Female Black/African American Medicare 18 11.7 P019 35–44 Female Asian Private 1 7.8 P020 55–64 Male White/Non-Hispanic Private 11 9.6 Note. Study codes have been used to replace all patient identifiers. Some of them were self-reported, including age group, sex, race/ethnicity, and insurance type. Week 1 EHR records revealed T2DM duration and baseline HbA1c. T2DM = type 2 diabetes mellitus; HbA1c = hemoglobin A1c. Table 2 Patient HbA1c Outcomes Across Measurement Time Points (N = 20) Participant ID Baseline HbA1c (%) Week 4 HbA1c (%) Week 8 HbA1c (%) Week 12 HbA1c (%) Change (Baseline to Wk 12) Target Met (<7%) P001 9.8 9.1 8.4 7.6 −2.2 No P002 10.2 9.6 8.8 7.9 −2.3 No P003 8.7 8.1 7.4 6.8 −1.9 Yes P004 11.1 10.3 9.2 8.4 −2.7 No P005 9.4 8.7 7.9 6.9 −2.5 Yes P006 10.8 10.0 9.1 8.2 −2.6 No P007 8.3 7.6 7.0 6.5 −1.8 Yes P008 9.9 9.2 8.3 7.4 −2.5 No P009 8.9 8.3 7.5 6.8 −2.1 Yes P010 11.4 10.7 9.6 8.7 −2.7 No P011 8.5 7.9 7.1 6.6 −1.9 Yes P012 10.6 9.8 8.9 7.8 −2.8 No P013 9.7 9.0 8.2 7.3 −2.4 No P014 10.9 10.2 9.3 8.5 −2.4 No P015 8.2 7.5 6.9 6.4 −1.8 Yes P016 9.3 8.6 7.8 6.9 −2.4 Yes P017 10.1 9.4 8.5 7.6 −2.5 No P018 11.7 10.9 9.8 8.9 −2.8 No P019 7.8 7.2 6.7 6.2 −1.6 Yes P020 9.6 8.9 8.0 7.2 −2.4 No Note.  The laboratory results, which were included in clinic EHR at Baseline (Week 1), Week 4, Week 8, and Week 12, were used to obtain values of HbA1c (percentages). Change score represents Week 12 HbA1c – Baseline HbA1c. Target achievement was set as: HbA1c < 7% ADA Standards of Care. HbA1c = hemoglobin A1c; ADA = American Diabetes Association. Table 3 Patient Follow-Up Adherence and Visit Completion Data (N = 20) Participant ID Scheduled Visits (n = 6) Completed Visits (n) Missed Visits (n) Telehealth Visits Used Completion Rate (%) P001 6 6 0 1 100 P002 6 5 1 0 83 P003 6 6 0 2 100 P004 6 4 2 1 67 P005 6 6 0 0 100 P006 6 5 1 2 83 P007 6 6 0 1 100 P008 6 6 0 0 100 P009 6 5 1 1 83 P010 6 4 2 2 67 P011 6 6 0 0 100 P012 6 6 0 1 100 P013 6 5 1 0 83 P014 6 6 0 2 100 P015 6 6 0 0 100 P016 6 5 1 1 83 P017 6 6 0 1 100 P018 6 4 2 2 67 P019 6 6 0 0 100 P020 6 5 1 1 83 Note. The 12-week implementation period was arranged to be followed up biweekly (6 visits per patient). Patients with transport or mobility limitations were provided with telehealth visits. Completion rate = completion visits/ 6, multiplying the result by 100. Table 4 Nursing Staff Competency Assessment Results (N = 8) Staff ID Role Pre-Training Score (/100) Post-Training Score (/100) Score Change Threshold Met (>=80%) Checklist Completion (%) S001 Nurse Practitioner 62 88 +26 Yes 95 S002 Nurse Practitioner 58 84