NURS FPX 9030 Assessment 2 Data and Data Analysis

Introduction

Diabetes mellitus is still one of the most common chronic diseases faced by patients during visits to primary care facilities. Over the last year at the project site, several patients did not achieve good control of diabetes, as evidenced by having 42% of patients with an A1c greater than 9% and only 36% of patients having an A1C less than 7 percent (Chief Nursing Officer, Personal Communication, October 10th, 2020). The percentages are much higher in comparison with national standards of diabetes management because they are around 22 percent of adults with diabetes with poor glycemic control and about 50 percent of them with A1C goals (Adjei et al., 2020; Chief Nursing Officer, Personal Communication, October 10th, 2020). The absence of a standardized, protocolized course of follow-up, with the possibility to at least receive education on diabetes, led to patients not receiving adequate education at all, and missing follow-up opportunities and less than optimal outcomes. To fill the gaps, a quality improvement (QI) initiative was carried out based on the following PICOT question: Among nursing personnel working with adult patients with diabetes (P), the introduction of the ADA diabetes follow-up protocol (I) in comparison with the current practice (C) in terms of its effects on glycemic control (O) in 8 weeks (T)? An eight-week project adopted an American Diabetes Association (ADA) diabetes follow-up protocol and assessed the effects of the protocol on the glycemic outcomes, clinical competency of staff, staff adherence to follow-up, and self-management behaviors in patients. The project design, data collection methods, statistical studies, and findings are reflected in the paper, and the evidence to prove that structured, evidence-based ADA follow-up protocols may lead to clinically significant outcomes in glycemic control is provided.

Project Design and Data Collection

The pre-post design was utilized by the project team to acquire baseline and post-intervention data of the 20 adult participants and 8 nurses who are enrolled in the project. Before the project started, IRB approval was taken care of, and necessary Health Insurance Portability and Accountability Act (HIPAA) compliance was established; to maintain anonymity, the names of all participants were substituted with coded ones. The pre-post project design is a frequently employed technique within quality improvement tests to analyze the data and accomplishments of well-organized clinical measures. It is based on a pre-post design framework to be an effective measure of the impact of structured intervention on achieving success in real-life healthcare environments (Mitchell et al., 2025). To yield a valid and reliable measure of clinical outcomes, data collection tools adopted in a quality improvement project need to be valid and reliable to generate an accurate measure of clinical outcomes (Kaplan et al., 2021). Discussing all data collection tools, their content validity was verified as strong, considering evaluation by experts and further consistent use of the same procedures to collect data during the project, which lasted eight weeks.

Data Analysis

The results obtained at the 8-week follow-up time on the quantitative outcomes were measured using both descriptive statistics to determine the impact of the ADA diabetes follow-up protocol on the glycemic results, the competence of the staff, and the self-management behaviors of the staff. Since there was a need to compare baseline vs. week 8 HbA1c values of the participants, the primary inferential statistics were t-tests to compare the mean differences of one group at two different times. Descriptive statistics (percentage) were produced to sum up the adherence rates to follow up, competency scores of the staff, and the checklist results of self-management. The projects of quality improvement need to be analyzed statistically in order that the team can understand whether the changes in observed outcomes are significant changes in clinical outcomes or mere accidents of chance (Mangory et al., 2021). Moreover, repeated measures (pre and post) can be performed using the same group of participants, which increases the sensitivity of the statistic and sluces individual variability (Chicco et al., 2025). All analyses were performed on de-identified data obtained in the EMR of the clinic and the standardized assessment tools; as a result, all analyses were done in summary tables to be easily interpreted.

Project Results

All outcome measures improved among the participants who joined the project compared to the measurements of outcomes at baseline. As an example, the mean HbA1c fell 1.52 percentage points (9.95 per cent to 8.22 per cent) in 8 weeks. The respondents who responded were extremely involved in utilizing the structured protocol given to them, according to the follow-up completion rate of 89.2. Following training, 7 of 8 (87.5%) of the nursing staff scored within the 80 percent competency range, with an average score of 59.0 percent before the training and 85.4 percent after training. The mean self-management engagement scores of those who attended week 8 were 7.4 out of 10, with 70% of those attending the week 8 fully compliant with the medications, 65% of those attending the week 8 regularly completing the daily monitoring of blood sugar levels. On the whole, the findings suggest general positive changes concerning the clinical outcome, operational outcome, and behavioral outcome domains of the participants who participated in the project. Tables 1 to 6 in Appendix A contain the results.

Project Outcomes

The project results evidence suggests that the application of the follow-up protocol offered by the American Diabetes Association (ADA) turned out to be effective in reaching meaningful changes in glycemic control, thus addressing the PICOT question. The resultant HbA1c mean decrease of 1.52 points surpassed the set criteria of success of 0.5 points and was clinically significant. Nonetheless, merely 10% of study participants had reached the target HbA1c (<7%); despite significant improvement observed after 8 weeks of intervention, it is likely that the full target would also need a more extended intervention. Participants had 67% of planned visits delivered because of transportation: this led to adverse glycemic patterns; ubiquitous barriers and transportation issues were other unanticipated results. Continuous improvement quality initiatives aimed at chronic disease management always reveal that organized, researched procedures result in measurable improvement (Endalamaw et al., 2024). Continuous tracking, adjustment intervention, and follow-up of at least 1 year of outpatient glycemic measurement patterns are necessary to make sure that the benefit provided by outpatient glycemic improvement programs is sustainable (Jahed et al., 2025). The project strengths were a high level of staff competency, a high level of follow-up adherence, and proper EHR documentation. Limitations were also associated with the short (8-week) length of intervention time; the results might not be applied to other groups of adults with diabetes in wider community-based clinical environments.

Conclusion

An 8-week trial on the use of the ADA diabetes follow-up protocol demonstrated that the use of the intervention resulted in substantial clinical outcomes in terms of glycemic control, increase in staff competency, compliance with follow-up, and self-management behaviour in adults with type II diabetes in a nurse-led primary care infrastructure. Even despite the still some limitations observed in the attainment of full glycemic target levels, the participants were only followed over a period of time. The results all indicate that promoting and enforcing standard evidence-based procedures of diabetes follow-up will result in increased success in enhancing the outcome of chronic diseases within the outpatient primary care environment through the application of a continuous process.