Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Elizabeth Molle

Abstract

About 1 in 3 adults in the United States have prediabetes, yet 8 in 10 of people are unaware of having this condition. The gap in timely diagnosis of prediabetes hinders opportunities for awareness of risk for type 2 diabetes (T2DM), self-management, and referral to preventative interventions. Individuals with undiagnosed prediabetes have 1.3 times higher risk for hospitalization. Extending prediabetes screening to the inpatient hospital setting offers opportunity to identify undiagnosed prediabetes. The purpose of this DNP project was to implement a prediabetes screening algorithm in the hospital setting to identify undiagnosed prediabetes and initiate patient education on preventative lifestyle modifications and coordinate outpatient follow-up. A prediabetes screening algorithm was developed through adaptation of American Diabetes Association guidelines and was used to screen patients admitted to an internal medicine unit using HbA1c testing over a 12-week period. A total of 41 patients met criteria for screening and of these individuals, 51% (n=21) were found to have abnormal HbA1c results. The rate of undiagnosed T2DM and prediabetes was 15% (n=6) and 36% (n=15), respectively. Implementation of patient education occurred in 52% (n=11) of patients, while 76% (n=16) had primary care follow-up arranged. Though limited by a small sample size, utilization of the prediabetes screening algorithm in the inpatient hospital setting was found to be feasible and effective in informing risk of prediabetes and T2DM. This project has potential to offer opportunities for preventative screening through identification of risk factors for undiagnosed prediabetes or T2DM and intervention prior to hospital discharge.

Comments

This is an Open Access Thesis.

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