2.50
Hdl Handle:
http://hdl.handle.net/10755/160489
Type:
Presentation
Title:
Rural Primary Care Utilization of ADA Guidelines
Abstract:
Rural Primary Care Utilization of ADA Guidelines
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2004
Author:Brokel, Jane, PhD, RN
Title:Director, Clinical Transformation
Contact Address:CON, 176 Pleasant Manor Drive, Waterford, MO, 48327, USA
The presence of endocrinologists within rural settings is limited, the reliance on nurse practitioners and physician assistants has increased, and only 3% of patients with diabetes receive all recommended interventions. The purpose of this study was to describe patient characteristics, patient outcomes, the evidence-based ADA clinic interventions, and the healthcare professional characteristics within five primary care practice models in rural setting. The conceptual framework illustrated variables used in the primary care workflow including: patient characteristics and outcomes, the ADA clinic interventions, and healthcare professional characteristics of rural primary care practices. The models included clinics with nurse practitioners, physician-nurse practitioners, physicians, physician-physician assistants, and a multidisciplinary team. The subjects were 25 clinics providing care through five different primary care practice models to patients seeking diabetes care during a two-year period. A retrospective descriptive design with secondary data analysis was used three databases describe patient characteristics and outcomes, the ADA clinic interventions used, and healthcare professional characteristics of each model. The results show that five clinic interventions, clinic office visits, lipid tests, foot exams and care, blood pressure recordings and self-monitored blood glucose checks, demonstrated significant difference among the five models. The Hemoglobin A1c tests averaged between 3.6-4.3 in 2-years within all models, which was half the ADA recommended number of tests. Less than 20% of patients in each model were in control with HgbA1c < 7% throughout the two-year period. The conclusions indicate that all five primary care practice models provided diabetes care interventions but none of the five models were providing interventions such as the Hemoglobin A1c test at a level recommended by the ADA. Therefore, improvements in primary care workflow using standardized data variables in the electronic health records could trigger clinical rules to remind primary care providers of recommended ADA clinic interventions.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleRural Primary Care Utilization of ADA Guidelinesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160489-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Rural Primary Care Utilization of ADA Guidelines</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Brokel, Jane, PhD, RN</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director, Clinical Transformation </td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">CON, 176 Pleasant Manor Drive, Waterford, MO, 48327, USA</td></tr><tr><td colspan="2" class="item-abstract">The presence of endocrinologists within rural settings is limited, the reliance on nurse practitioners and physician assistants has increased, and only 3% of patients with diabetes receive all recommended interventions. The purpose of this study was to describe patient characteristics, patient outcomes, the evidence-based ADA clinic interventions, and the healthcare professional characteristics within five primary care practice models in rural setting. The conceptual framework illustrated variables used in the primary care workflow including: patient characteristics and outcomes, the ADA clinic interventions, and healthcare professional characteristics of rural primary care practices. The models included clinics with nurse practitioners, physician-nurse practitioners, physicians, physician-physician assistants, and a multidisciplinary team. The subjects were 25 clinics providing care through five different primary care practice models to patients seeking diabetes care during a two-year period. A retrospective descriptive design with secondary data analysis was used three databases describe patient characteristics and outcomes, the ADA clinic interventions used, and healthcare professional characteristics of each model. The results show that five clinic interventions, clinic office visits, lipid tests, foot exams and care, blood pressure recordings and self-monitored blood glucose checks, demonstrated significant difference among the five models. The Hemoglobin A1c tests averaged between 3.6-4.3 in 2-years within all models, which was half the ADA recommended number of tests. Less than 20% of patients in each model were in control with HgbA1c &lt; 7% throughout the two-year period. The conclusions indicate that all five primary care practice models provided diabetes care interventions but none of the five models were providing interventions such as the Hemoglobin A1c test at a level recommended by the ADA. Therefore, improvements in primary care workflow using standardized data variables in the electronic health records could trigger clinical rules to remind primary care providers of recommended ADA clinic interventions.</td></tr></table>en_GB
dc.date.available2011-10-26T22:59:29Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:59:29Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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