The Impact of Diabetic Education on Diabetes Management: A Retrospective Chart Review.

ABSTRACT: Helping patients control diabetes mellitus (DM) and minimize complications is the top priority for care of patients with diabetes. A retrospective review of 86 charts was conducted to investigate the impact of an 8-hour diabetic education program on glycemic control and weight in adults with type 2 DM. Hemoglobin A1C levels and weights were documented pre- and postintervention. Patients participating in the program demonstrated decreased levels of mean A1C and mean weight postintervention. Spiritual care for people living with diabetes and the use of continuous glucose monitors to improve disease management are discussed.

Reducing Hospital Visit Rates in Hospice Patients Using Telemedicine.

The purpose of this project was to examine the impact of accessibility to a provider via telemedicine on emergency department visit rates in adults, 35 years and older, on home hospice and palliative care. Utilizing a quasi-experimental design, 44 adults 35 years and older were educated on Doxy.me telemedicine usage as an intervention. Measures included gender, diagnosis, age, the reason for contact, and outcome (intervention group only); the number of emergency department visits, the number of 911 calls, and the number of discharges/transfers (control and intervention) in the 8 weeks after the evidence-based telemedicine intervention. Statistical analyses were performed to examine the number of emergency department visits and 911 calls preintervention and postintervention among all participants. A total of eight teletechnology calls were documented from a patient or patient caregiver. Among the intervention group, the number of emergency department visits and the number of 911 calls decreased from 12 (54.5%) to one (4.5%) postintervention. Paired-samples t tests show there were statistically significant differences in the number of emergency department visits and 911 calls between the two points in time. In conclusion, a telemedicine hospice care application may benefit a palliative and hospice organization by enhancing patient clinical outcomes and decreasing emergency department visit rates.

Provider Prescription Drug Monitoring Program Utilization and Self-Auditing-A Pilot Study.

BACKGROUND: Alabama has the highest prescription rate in the country. The national incidence of overdose deaths from prescription opioids exceeds the combined death rates from heroin and cocaine overdose. Monitoring prescription access should be an essential activity among providers and can be used to protect patient health and well-being. Prescription drug monitoring programs (PDMPs) are tools that assist in diminishing opioid therapy risks such as diversion, abuse, overdose, and death. OBJECTIVE: The purpose of the study was to examine the effects of an educational intervention on opioid prescriptive rates, frequency of self-auditing and days of opioid supply among healthcare providers. The anticipated goal of the project was that rates and days of supply for opioid prescriptions would decrease. METHOD: A pretest-posttest design was used to assess a sample of 21 DEA licensed providers who attended a PDMP presentation and conducted a self-audit using the PDMP. RESULTS: Analysis showed that 81% of the participants had never conducted a self-audit prior to the intervention. Self-report data indicated that 85.7% of the providers planned to increase their self-auditing use postintervention and 14.3% planned to make no changes to their current use of the PDMP. Among those who prescribed opioids, the range of monthly prescriptions written was 3-142 preintervention (M = 32.28, SD = 41.04) and 3-149 postintervention (M = 32.26, SD = 43.32). Analysis also found the days of opioid supply prescribed were also high. In both cases, these numbers were correlated to patient census. IMPLICATIONS FOR NURSING: The PDMP is an effective surveillance tool that provides aggregate data to state public health officials. For a PDMP to be effective, it must be used by prescribing providers. While the anticipated goal for this study was not achieved, the PDMP is an effective surveillance tool for monitoring the controlled substance prescription histories of patients. Using the PDMP before prescribing can aid providers in distinguishing those who legitimately have a need from those who may be seeking to misuse the medications. Additionally, use of a PDMP can provide aggregate data to state public health officials so that education programs, for practitioners and patients, can be developed.

An educational intervention to improve pain assessment in preverbal children.

PROBLEM: Pediatric nurses often use an inappropriate tool to assess pain in children younger than 36 months of age. OBJECTIVE: This intervention intended to improve the nursing practice of assessing pain in preverbal (less than 36 months of age) children. METHODS: Pain assessment frequency and use of a pain assessment pediatric tool use was evaluated pre- and post-intervention via a retrospective chart review and a survey of pediatric nurses. Parametric and non-parametric statistical tests were used to determine significant differences between pre- and post-intervention data for both approaches. RESULTS: The chart review data showed a significant increase in the number of times pain was assessed and documented post-educational intervention. Similarly, the survey data analysis showed a significant post-intervention increase in the use of a pain assessment tool and that most nurses used the FLACC pain assessment tool when assessing pain in preverbal children. CONCLUSION: Educating staff nurses about the use of an appropriate pain assessment scale altered practice and improved the frequency of pain assessment of preverbal children.