Martha Guzman, DNP, FNP-BC, FNP-C, PHN

DNP: California State University, Fresno

Project Title: Applying the Chronic Care Model to Improve Prediabetes Screening

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There is growing evidence that prediabetes is more than just a precursor to type 2 diabetes mellitus (T2DM). It is a silent but serious medical condition that is linked with long-term damage to various tissues and organs. Since prediabetes often has no symptoms, patients and medical providers frequently underestimate its potential harmful effects. Unfortunately, the utilization of evidence-based practice (EBP) screening guidelines for prediabetes remains low. Through a quasi-experimental, mixed-method, quality improvement (QI) approach, this study evaluates the effects of the multicomponent Chronic Care Model (CCM) interventions on provider prediabetes screening outcomes using the Center for Disease Control and Prevention/ American Diabetes Association (CDC/ADA) prediabetes risk test, and the new order set Z13.1. Study outcomes were measured by the frequency of prediabetes screening code Z13.1 documentation in the medical record for non-diabetic adults aged 18 to 75.

This project was implemented over two months. During this period, the number of patients screened significantly increased. Four hundred and three non-diabetic patients received screening, and 159 were identified as at risk for prediabetes. Of the 159 patients, 136 were screened using the new Z13.1 order set. Out of 136 high-risk patients, 26 (19.1%) were diagnosed with prediabetes, and another 4 (2.9%) were diagnosed with T2DM. Prediabetes screening and detection can lower the risk of future comorbidities and associated complications.

Dr. Heidi He