Show simple item record

dc.contributor.advisorRuel, Jenniferen
dc.contributor.advisorMcArthur, Donna B.en
dc.contributor.authorNelson, DeAnn Lynn
dc.creatorNelson, DeAnn Lynnen
dc.date.accessioned2017-09-27T22:19:54Z
dc.date.available2017-09-27T22:19:54Z
dc.date.issued2017
dc.identifier.urihttp://hdl.handle.net/10150/625670
dc.description.abstractBackground: Type 2 diabetes mellitus (T2DM) is a major health concern among Navajo Indians. Native Americans and Alaskan Natives (NA/AN) currently have the highest rates of T2DM in the United States (Indian Health Service, 2016). The rate of diabetes on the Navajo Indian reservation is 22% (Partnersinhealth.org, 2009). Major health concerns for patients with T2DM include cardiovascular complications. Treatment is essential to prevent high-risk complications such as, cardiovascular disease (CVD). Purpose: The purpose of this quality improvement project was to implement a clinical decision support tool (CDST) to increase primary care provider awareness of current American Diabetes Association (ADA) statin therapy guidelines. The first objective was to increase the prescription rates of statin medications by 10%. The second objective of this project was to increase the performance target rate by 10%. Setting: This project was implemented at the Gallup Indian Medical Center (GIMC) Family Medicine Clinic. GIMC is located in Gallup, New Mexico. Participants: Participants included primary care providers, six Medical Doctors, two Nurse Practitioners, and one Physician Assistant. Methods: An evidence based clinical support decision tool (CDST) was generated the ADA statin therapy guidelines. Participants were educated on these practice guidelines and the CDST. The CDST was implemented into the electronic health record (EHR) over a four-week period. The provider used the CDST as a point-of-care guide when prescribing statin therapy to those with T2DM. Results: There was a 0.5% increase in the GPRA performance rating at GIMC as well as a 10% increase in prescribed statin therapy medications. There were 253 newly prescribed statin medications during data collection. Conclusion: While this project did not result in significant improvement of statin therapy GPRA performance ratings, a new EHR tool that providers can use to improve patient care was implemented. One outcome was met, there was a 10% increase in statin medication prescriptions. Further studies and future PDSA cycles will be required for testing the effectiveness of CDSTs.
dc.language.isoen_USen
dc.publisherThe University of Arizona.en
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en
dc.subjectCardiovascular Diseaseen
dc.subjectClinical Decision Supporten
dc.subjectDiabetes Type 2en
dc.subjectNative Americansen
dc.subjectNavajo Indiansen
dc.subjectStatin Therapyen
dc.titlePromoting the Use of Statin Therapy in Navajo Patients with Type 2 Diabetesen_US
dc.typetexten
dc.typeElectronic Dissertationen
thesis.degree.grantorUniversity of Arizonaen
thesis.degree.leveldoctoralen
dc.contributor.committeememberRuel, Jenniferen
dc.contributor.committeememberMcArthur, Donna B.en
dc.contributor.committeememberBrown, Angelaen
thesis.degree.disciplineGraduate Collegeen
thesis.degree.disciplineNursingen
thesis.degree.nameD.N.P.en
refterms.dateFOA2018-09-11T23:14:53Z
html.description.abstractBackground: Type 2 diabetes mellitus (T2DM) is a major health concern among Navajo Indians. Native Americans and Alaskan Natives (NA/AN) currently have the highest rates of T2DM in the United States (Indian Health Service, 2016). The rate of diabetes on the Navajo Indian reservation is 22% (Partnersinhealth.org, 2009). Major health concerns for patients with T2DM include cardiovascular complications. Treatment is essential to prevent high-risk complications such as, cardiovascular disease (CVD). Purpose: The purpose of this quality improvement project was to implement a clinical decision support tool (CDST) to increase primary care provider awareness of current American Diabetes Association (ADA) statin therapy guidelines. The first objective was to increase the prescription rates of statin medications by 10%. The second objective of this project was to increase the performance target rate by 10%. Setting: This project was implemented at the Gallup Indian Medical Center (GIMC) Family Medicine Clinic. GIMC is located in Gallup, New Mexico. Participants: Participants included primary care providers, six Medical Doctors, two Nurse Practitioners, and one Physician Assistant. Methods: An evidence based clinical support decision tool (CDST) was generated the ADA statin therapy guidelines. Participants were educated on these practice guidelines and the CDST. The CDST was implemented into the electronic health record (EHR) over a four-week period. The provider used the CDST as a point-of-care guide when prescribing statin therapy to those with T2DM. Results: There was a 0.5% increase in the GPRA performance rating at GIMC as well as a 10% increase in prescribed statin therapy medications. There were 253 newly prescribed statin medications during data collection. Conclusion: While this project did not result in significant improvement of statin therapy GPRA performance ratings, a new EHR tool that providers can use to improve patient care was implemented. One outcome was met, there was a 10% increase in statin medication prescriptions. Further studies and future PDSA cycles will be required for testing the effectiveness of CDSTs.


Files in this item

Thumbnail
Name:
azu_etd_15829_sip1_m.pdf
Size:
428.9Kb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record