使用移动医疗增加服务不足人群糖尿病护理的可及性:移动诊所的护理点检测如何加强弱势和服务不足人群的血红蛋白A1c依从性

IF 0.2 Q4 NURSING Journal of Doctoral Nursing Practice Pub Date : 2021-11-01 DOI:10.1891/JDNP-D-20-00066
Rebecca Owen, Mary Wyckoff, Rebecca Rogers
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引用次数: 0

摘要

背景:美国疾病控制与预防中心(CDC)报告称,2018年美国有2690万人患有糖尿病,糖尿病诊出率为9.4%,相当于人口的8.2% (CDC, 2020年)。主要政府组织制定了临床质量指标(CQIs),以确保患者得到充分的护理。综合糖尿病护理的cqi是复杂的,往往表明弱势群体的护理差距。目的:评估移动诊所提供即时护理(POC)血红蛋白A1c (HbA1c)检测是否能提高弱势人群CQIs的依从性。方法:本循证临床实践改变项目(EBCPCP)侧重于通过在联邦合格卫生中心(FQHC)流动诊所实施POC HbA1c检测来改善弱势人群的糖尿病cqi。结果:125名接受HbA1c检测的患者表明,在移动设备上进行POC HbA1c检测增加了HbA1c检测。在POC检测可用之前,没有患者完成HbA1c实验室。结论:移动诊所的POC检测增加了弱势人群获得HbA1c的机会,从而改善了实践结果并增加了CQI依从性。对护理的启示:EBCPCP的结果表明,POC测试增加了获得诊断和护理的机会。
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Increasing Access to Diabetes Care in Underserved Populations Using Mobile Medicine: How Point-of-Care Testing on Mobile Clinics Strengthens Hemoglobin A1c Adherence in Vulnerable and Underserved Populations.

Background: The Center for Disease Control and Prevention (CDC) reported 26.9 million individuals a diabetes diagnosis rate of 9.4% in the United States had diabetes in 2018, equivalent to 8.2% of the population (CDC, 2020). Key government organizations have developed clinical quality indicators (CQIs) to ensure patients receive adequate care. The CQIs for comprehensive diabetes care are complex and often indicate a gap-in-care among vulnerable populations.

Objective: To evaluate if the availability of point-of-care (POC) hemoglobin A1c (HbA1c) testing in a mobile clinic increases CQIs adherence in vulnerable populations.

Methods: This evidence-based clinical practice change project (EBCPCP) focused on improving diabetic CQIs in vulnerable populations by implementing POC HbA1c testing on a federally qualified health centers (FQHC) mobile clinic.

Results: The results, 125 individuals having received HbA1c results, indicate having POC HgbA1c testing available on the mobile unit increased HbA1c testing. No patients had an HbA1c lab completed prior to the availability of POC testing.

Conclusion: The availability of POC testing on a mobile clinic increases access to HbA1c for vulnerable populations which improves practice outcomes and increased CQI adherence.

Implications for nursing: The results of this EBCPCP indicate POC testing increases access to diagnostics and care.

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