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Increasing Postpartum Glucose Screen...

Fox, Kira Miyuki.

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Increasing Postpartum Glucose Screening for Women with Gestational Diabetes Mellitus.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Increasing Postpartum Glucose Screening for Women with Gestational Diabetes Mellitus./
Author:	Fox, Kira Miyuki.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2023,
Description:	55 p.
Notes:	Source: Dissertations Abstracts International, Volume: 85-03, Section: B.
Contained By:	Dissertations Abstracts International85-03B.
Subject:	Nursing. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30490560
ISBN:	9798380404563

Increasing Postpartum Glucose Screening for Women with Gestational Diabetes Mellitus.
Fox, Kira Miyuki.

Increasing Postpartum Glucose Screening for Women with Gestational Diabetes Mellitus. - Ann Arbor : ProQuest Dissertations & Theses, 2023 - 55 p.

Source: Dissertations Abstracts International, Volume: 85-03, Section: B.

Thesis (D.N.P.)--University of Hawai'i at Manoa, 2023.

This item must not be sold to any third party vendors.

Importance: Gestational diabetes mellitus (GDM) is an indicator of future health risks, with up to 70% of women diagnosed with GDM developing diabetes mellitus in their lifetime. Despite postpartum glucose screening recommendations, less than half of all women will complete an oral glucose tolerance test (OGTT) after giving birth. Improvement of guideline concordant postpartum glucose tolerance screening will allow opportunity to initiate early detection and intervention to prevent progression of GDM to diabetes mellitus.Methods: This quality improvement project implemented a multifaceted clinical protocol at a maternal-fetal medicine (MFM) clinic and diabetes in pregnancy program to improve provider and patient adherence to the American College of Obstetrics and Gynecology and the American Diabetes Association recommendations for postpartum glucose tolerance screening. Interventions included standardization of provider workflow, standardization of patient education, and a patient reminder system implemented at the '38-week' ultrasound appointment. De-identified aggregate data was analyzed to determine differences in patient adherence to a 2hr OGTT at 4-12 weeks postpartum between pre- and post-intervention groups.Results: The non-identifiable patient electronic medical records of 246 women were included in the pre-intervention group, and the records of 79 women were included in the post-intervention group. Provider adherence to ordering a postpartum OGTT for patient significantly increased from one patient (0.4%) in the pre-intervention group to 47 patients (59.5%) in the post-intervention group (p<.001). There was a nonsignificant increase in patient adherence to guideline concordant postpartum OGTT completion between pre- and post-intervention groups (p = .905). Patient attendance at the '38-week' ultrasound appointment at which the clinical protocol and patient education was implemented was significantly associated with adherence to guideline concordant postpartum testing (p = .018).Conclusion: Patient education and GDM postpartum care planning should start in the antenatal period to increase provider and patient adherence to guideline concordant postpartum glucose tolerance screening. MFM providers have an opportunity to improve GDM-related care during the transition from postpartum to primary care.

ISBN: 9798380404563Subjects--Topical Terms:

528444
Nursing.
Subjects--Index Terms:

Clinical protocol

Increasing Postpartum Glucose Screening for Women with Gestational Diabetes Mellitus.
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500 $a Source: Dissertations Abstracts International, Volume: 85-03, Section: B.
500 $a Advisor: Fontenot, Holly.
502 $a Thesis (D.N.P.)--University of Hawai'i at Manoa, 2023.
506 $a This item must not be sold to any third party vendors.
520 $a Importance: Gestational diabetes mellitus (GDM) is an indicator of future health risks, with up to 70% of women diagnosed with GDM developing diabetes mellitus in their lifetime. Despite postpartum glucose screening recommendations, less than half of all women will complete an oral glucose tolerance test (OGTT) after giving birth. Improvement of guideline concordant postpartum glucose tolerance screening will allow opportunity to initiate early detection and intervention to prevent progression of GDM to diabetes mellitus.Methods: This quality improvement project implemented a multifaceted clinical protocol at a maternal-fetal medicine (MFM) clinic and diabetes in pregnancy program to improve provider and patient adherence to the American College of Obstetrics and Gynecology and the American Diabetes Association recommendations for postpartum glucose tolerance screening. Interventions included standardization of provider workflow, standardization of patient education, and a patient reminder system implemented at the '38-week' ultrasound appointment. De-identified aggregate data was analyzed to determine differences in patient adherence to a 2hr OGTT at 4-12 weeks postpartum between pre- and post-intervention groups.Results: The non-identifiable patient electronic medical records of 246 women were included in the pre-intervention group, and the records of 79 women were included in the post-intervention group. Provider adherence to ordering a postpartum OGTT for patient significantly increased from one patient (0.4%) in the pre-intervention group to 47 patients (59.5%) in the post-intervention group (p<.001). There was a nonsignificant increase in patient adherence to guideline concordant postpartum OGTT completion between pre- and post-intervention groups (p = .905). Patient attendance at the '38-week' ultrasound appointment at which the clinical protocol and patient education was implemented was significantly associated with adherence to guideline concordant postpartum testing (p = .018).Conclusion: Patient education and GDM postpartum care planning should start in the antenatal period to increase provider and patient adherence to guideline concordant postpartum glucose tolerance screening. MFM providers have an opportunity to improve GDM-related care during the transition from postpartum to primary care.
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653 $a Patient education
653 $a Postpartum
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