Effectiveness of Nursing Care Plans Based in Nursing Diagnoses in Metabolic Control of Type 2 Diabetes Mellitus
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Purpose
Background: Nurses in clinical practice implement care to patients with Type 2 diabetes mellitus (DM2) in order to maintain normal blood glucose readings, promote weight loss and provide nutrition counseling to improve metabolic and blood pressure control. Because many disciplines contribute to patient's health outcomes, it is important to distinguish how nurses contribute to patient care and the achievement of health outcomes and the differences between the use or not the classification of Nursing Diagnoses, and the Nursing Interventions Classification (NIC) in clinical practice settings.
Methods: Prospective observational study with 2-year follow-up to assess the effect of Nursing Care Plans based on Scientific Methodology (NCPSM) on changing the control parameters in routine clinical practice conditions.
Settings: 31 Primary care centers in northeastern urban area of Madrid (Spain). Subjects: 24,124 DM2 patients (full universe).
| Condition |
|---|
|
Type 2 Diabetes Mellitus Cardiovascular Risk Factors |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Effectiveness of Implementing Nursing Care Plans Based on Scientific Methodology in Improving Metabolic and Blood Pressure Control of Type 2 Diabetes Mellitus Patients. |
- HbA1c level [ Time Frame: Final (before 4 years follow-up) ] [ Designated as safety issue: No ]
- Blood Pressure [ Time Frame: Final (before 4 years follow-up) ] [ Designated as safety issue: No ]
- Low-density lipoprotein (LDL) cholesterol [ Time Frame: Final (before 4 years of follow-up) ] [ Designated as safety issue: No ]
- Body Mass Index (BMI) [ Time Frame: Final (before 4 years of follow-up ] [ Designated as safety issue: No ]
| Enrollment: | 23488 |
| Study Start Date: | January 2008 |
| Study Completion Date: | November 2011 |
| Primary Completion Date: | December 2009 (Final data collection date for primary outcome measure) |
The computerized clinical record system (CCR) form for primary care of the Madrid Health Service was used as the data source. NCPSM was identified by clinical records of NANDA and NIC nursing taxonomies, and were defined as nursing care based on the following three criteria:
Criterion 1.- A patient's CCR must register valuation data based on Marjory Gordon "functional pattern" in at least the following areas:
- Health perception
- Nutritional-metabolic
- Activity-exercise. Criterion 2.- The problems identified and the proper management of treatment will be described using coded diagnoses with NANDA.
Criterion 3.- The nursing interventions carried out by standardized language will be registered according to the NIC taxonomy.
Eligibility criteria for patients were: older than 30 years of age, with previously diagnosed diabetes (cardinal clinical, plus random blood glucose >200 mg/dl or oral glucose of >200 mg/dl at 2 h, twice, or plasma fasting glucose of >126 mg/dl on two occasions or being diagnosed previously, received specific treatment for diabetes) and exclusion criteria were: gestational diabetes, patients involved in clinical trials, patients with life expectancy of less than one year (according to clinical judgment), homebound patients.
The primary outcome was HbA1c, lipid levels, blood pressure, and BMI after 24 and 48 months of follow-up.
Eligibility| Ages Eligible for Study: | 30 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
23,488 DM2 patients (full universe).
Inclusion Criteria:
- older than 30 years of age,
- with previously diagnosed diabetes (cardinal clinical, plus random blood glucose > 200 mg/dl or oral glucose of >200 mg/dl at 2 h, twice, or plasma fasting glucose of >126 mg/dl on two occasions or being diagnosed previously, received specific treatment for diabetes)
Exclusion Criteria:
- gestational diabetes,
- patients involved in clinical trials,
- patients with life expectancy of less than one year (according to clinical judgment),
- homebound patients
Contacts and Locations| Spain | |
| Gerencia Atención Primaria | |
| Madrid, Spain, 28029 | |
| Study Director: | JUAN CARDENAS | Atención Primaria Madrid |
More Information
No publications provided by Hospital Carlos III, Madrid
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Miguel Angel Salinero Fort, MD, Hospital Carlos III, Madrid |
| ClinicalTrials.gov Identifier: | NCT01482481 History of Changes |
| Other Study ID Numbers: | PI070865, 070865 |
| Study First Received: | November 27, 2011 |
| Last Updated: | November 29, 2011 |
| Health Authority: | Spain: Ministry of Health and Consumption |
Keywords provided by Hospital Carlos III, Madrid:
|
Patient Care Planning Type 2 Diabetes Mellitus Cardiovascular Risk Factors Primary Health Care Spain |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |
ClinicalTrials.gov processed this record on May 19, 2013