Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-11-2019

Graduate Advisor

Alicia Hutchings, PhD, RN, CNE

Committee

Natalie Murphy, PhD, APRN, FNP-BC

David Campbell, MD

Abstract

Purpose: This project evaluated current practices for Type 2 diabetes mellitus (T2DM) screening and management among Asian Americans (AAs) presenting to a primary care clinic and determined whether these practices adhered to the American Diabetes Association (ADA)’s 2018 guidelines.

Methods: A retrospective chart review was performed to extract data from clinical case records of AAs who visited the Vietnamese Health Center (VHC) between November 1, 2017 and November 1, 2018. Descriptive statistics were utilized to analyze the data.

Results: Of 173 charts reviewed, 76.3% of AAs had no previous T2DM diagnosis and 23.7% had a previous diagnosis. Among those without a previous T2DM diagnosis, approximately 85% were screened per ADA guidelines and 4.1% of the screenings resulted in a positive finding. Among AAs with a previous T2DM diagnosis, 58.5% received routine hemoglobin A1c monitoring, 2.4% had a comprehensive foot exam, and 7.3% had a dilated eye exam. Annual screening of a lipid profile, serum creatinine, estimated glomerular filtration rate, and urine albumin-to-creatinine ratio (UACR) were performed on 90.2%, 92.7%, 92.7%, and 0% of diabetic AAs, respectively.

Conclusion: This project provided a baseline assessment of T2DM screening and management among AAs, specifically among the Vietnamese population. While a majority were screened per ADA guidelines, gaps in care were identified in the management of diabetic AAs. It is recommended that VHC focus its quality improvement efforts toward increasing the percentage of comprehensive foot exams, referral for dilated eye exams, and UACRs performed annually. Addressing these gaps in care may reduce disparities in health faced by AAs.

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