Implementation of a Self Management Diabetes Program in the Corporate and Community Setting Rhonda M

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Implementation of a Self Management Diabetes
Program in the Corporate and Community
SettingRhonda McAnally, RN BSN CEN
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Background

• Conducted corporate and community needs
  assessment
• Identified interest in Diabetes Education
• Developed an educational program focused on self
  management of Type 2 Diabetes
• Obtained corporate and community health
  organization support
• Targeted 21 counties to serve

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Objectives

• Increase the patients ability to successfully
  self manage and understand Type 2 Diabetes
• Emphasize preventive strategies among those at
  risk in developing Type 2 Diabetes
• Developing a best practice model of care
  deliverable across multiple community based
  settings
• Evaluate the effectiveness of the CDMP among
  participants

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Program Focus-Objectives
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Educational Team

• Registered Nurses
• Pharmacists
• Registered Dieticians
• Certified Diabetes Educators

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Initial Program Design

• Informed consent obtained by all participants
• Private, face-to-face counseling sessions with
  nurse, pharmacist, or dietician at each location
• Employees at corporate locations were allowed to
  use work hours for program participation
• Community participants were scheduled in
  healthcare providers offices
• Initial visit with LDL and Hgb A1c
• 45 minutes
• 6 educational sessions
• 30 minutes each
• Follow up at 6 months and 1 year with LDL and Hgb
  A1c

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Potential Barriers to Learning Reported During
Initial Visit

• 51 No Barriers
• 26 Other
• 7 Vision
• 6 Reading/ Low literacy
• 5 Hearing
• 2 Language
• 2 Denial of Diabetes
• 1 Lack of Family Support/ Work schedule

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Incentives offered for interval achievements

• Pedometers
• Water bottles
• Daily Journals
• Education notebook
• Tee Shirts
• Gift cards for food purchase

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Program Outcomes

• Enrolled 300 individuals at program onset
• 256 individuals successfully completed program by
  June 2009.
• Participants at corporate locations had better
  program participation rates than community based
  educational programs
• Knowledge assessments completed

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Program Outcomes
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Program Screening Results
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Program Survey

• A 7 question program survey was offered to the
  256 patients who completed the program.
• Questions 1-6 asked participants to rank
  different aspects of the program by indicating
  that they were very satisfied, moderately
  satisfied, neither, moderately dissatisfied, or
  very dissatisfied.
• The last question of our survey asked if they
  would recommend the program to others.

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Survey Responses

• Individuals who did not complete program
• reported the following barriers
• Transportation
• Too many sessions
• Finances

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Program Survey Results
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Change In Program

• In an effort to provide diabetes education to a
  larger population base encompassing a 21 county
  area, the structure was altered to offer programs
  to satisfy the needs of the targeted population
  being served, while still providing the same
  education curriculum.

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4 Class Structures

• 7 sessions over 14 weeks
• 3 sessions over 6 weeks
• 1 day group sessions
• 2 day group sessions

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Lessons Learned

• Participants appreciated the opportunity of
  receiving education outside of normal traditional
  settings of physician practices or hospitals
• Participants enjoyed interactive sessions
  involving activities related to nutrition and
  exercise

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Lessons Learned

• Educational format for future community classes
  were altered due to reports of transportation
  difficulties and financial hardships for the
  participants in the rural counties.
• Classes were offered in one day group sessions to
  increase participation and completion rates.

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Success Story

• Male, 30s, morbidly obese
• Elevated glucose at wellness screening.
• Confirmed Type 2 Diabetes by MD, placed on oral
  medication and insulin.
• Began program in March 2008.
• Program Completion- lost 100lbs with diet and
  exercise, off all medications

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Conclusions

• Educational materials and interactive disciplined
  sessions are effective ways to increase awareness
  and understanding of Type 2 diabetes.
• Participants must adhere and accept modifications
  in diet, lifestyle, and exercise to manage Type 2
  Diabetes successfully.