Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-6-2022

Graduate Advisor

Cathy Koetting, College of Nursing

Committee

Cathy Koetting, PhD, DNP, APRN, CPNP-PC, PMHS, FNP-C

Charity Galgani, DNP, WHNP-BC

Elizabeth Slais, MSN, RN

Abstract

Implementation of Postpartum Oral Glucose Testing Follow-up in Women with Gestational Diabetes

Problem One of the most common medical complications of pregnancy is Gestational Diabetes (GDM). After delivery, guidelines recommend follow-up glucose tolerance testing (OGTT) 4-to 12-weeks postpartum. Despite these recommendations, only 16% to 22% of women complete an OGTT postpartum.

Methods The purpose of this quality improvement (QI) project is to pilot a postpartum outreach follow-up via telephone to reach women diagnosed with GDM; the communication will be sent using the institution’s electronic messaging system. Quantitative data were collected prospectively. Data collected included if the patient was contacted and if the patient completed the testing. This project took place in a women's health clinic. This project used a purposive sample of women, aged 18 – 45, diagnosed with GDM.

Results The sample was composed of a total of 24 women in the pre-implementation period and 17 women in the post-implementation period. The pre-implementation period showed seven women (29.2%) completed the OGTT, and 17 (70.8%) did not. In the post-implementation period, six women (35.3%) completed the OGTT, and 11 (64.7%) did not. The postpartum outreach achieved 100% communication from the office to the patient by telephone or electronic message.

Implications for Practice In this QI effort, the piloted change helped engage more patients before their 6-week postpartum office visit. Future recommendations for this QI project include another PDSA cycle of a longer duration to evaluate the quality of care and new knowledge in promoting responsiveness between patient and provider to achieve the goal of increasing completion of the postpartum testing in women with GDM.


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