Date of Conferral



Doctor of Nursing Practice (DNP)




Joan Moon


Lack of access to healthcare in rural communities has resulted in increased morbidity and mortality rates among diabetic patients. The problem identified in this project was the lack of access to healthcare among diabetic patients living in rural southeast Ohio. Tele-healthcare is a strategy that provides healthcare remotely and has been introduced into the rural setting and offers an appropriate healthcare delivery mode for the rural community. The purpose of the project was to develop a tele-healthcare clinical practice guideline, including smart phone applications, for the management of diabetic patients. An expert panel consisting of 2 advanced practice nurses in diabetic education and endocrinology as well as the director of nursing of the local health department scored the guideline using the Appraisal of Guidelines Research and Evaluation II model, which consisted of 23 items over 6 domains. Results were calculated by adding the maximum score expressed as a percentage and dividing by 6 domains. The result was 96.8%. The threshold for a high-quality guideline is 70%. Recommendations by the panel were implementation of the guideline incorporating smartphone applications into the process of providing care for diabetic patients as a way of increasing access and improving the quality of diabetic healthcare among rural populations. Using a tele-healthcare clinical practice guideline for diabetic management might achieve positive social change by expanding access to healthcare as well as improving the overall quality of healthcare services for diabetic patients living in rural southeast Ohio.

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