Date of Conferral

2021

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Dr. Deborah Lewis

Abstract

AbstractDiabetes is a major cause of increased disease burden and cost of care for patients in long-term care (LTC) settings. Of common diabetes-related complications, hypoglycemia has the most catastrophic implications for this population. Poor understanding, reporting, and management of hypoglycemia by LTC staff can cause increased diabetes-related hospitalizations, disability, deaths, and financial burden for LTC patients and nursing homes. This DNP project focuses on developing a clinical guideline to address the recognition and management of hypoglycemia in LTC settings. It will advance the skills and knowledge of LTC staff regarding hypoglycemia management. The project is grounded in nursing theoretical models including the John Hopkins nursing evidence-based practice model, Neuman’s system model, and Roy’s adaptation model. The 2019 Walden Clinical Practice Guideline Manual guided the development of the clinical guideline, based on data from randomized control trials, meta-analyses, expert opinion, and review by the LTC stakeholders. A review panel including an endocrinologist, a nurse practitioner, a member of the local diabetes practice guidelines committee, and an expert from the hypoglycemia support foundation appraised the clinical guideline using the AGREE II instrument. The aggregate scores across the six areas of the AGREE II instrument ranged between 80-95%. All reviewers agreed that they would use the instrument, two reviewers made recommendations for modification and those modifications were made in the final version of the clinical guideline. This DNP project will support social change by helping to reduce the average medical expenditure per diabetic patient receiving long-term care and improve the overall quality of life outcomes for this population.

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