Program Evaluation: Clinical Nurse Specialist Led Program for Diabetes Health

The increasing prevalence of diabetes in the United States indicates that healthcare providers will likely encounter patients in the acute care setting with a diagnosis of diabetes, even if that is not the chief complaint or medical concern that led to the hospital admission. A systematic literature search shows that Advanced Practice Nurses (APRNs) deliver care that is comparable to physician colleagues in meeting target blood glucose levels. Utilizing the Agency for Clinical Innovation’s (ACI) program evaluation framework, a program evaluation was conducted on the Clinical Nurse Specialist (CNS)-led Program for Diabetes Health (PDH). The program evaluation examined clinical outcomes achieved by the PDH providers compared to clinical outcomes achieved by providers prior to the initiation of the PDH. Utilizing a retrospective electronic health record review, data were collected on patients over a three-month period prior to the implementation of the PDH and the same three-month period nearly two-and-a-half years post implementation. Data points were collected on nine different variables to compare demographics and diabetes management during the two time periods. Data were analyzed. There were statistically significant differences in the results for difference in group ages, admitting blood glucose levels, length of stay, use of basal/bolus insulin and use of sole correctional insulin. The results of the statistical tests and further analysis show that the CNSs of the PDH provide care that is consistent with the current clinical guidelines. Additionally, despite increased blood glucose values on admission, the results point to an increased number of patients who achieved target blood glucoses with a reduced number of hypoglycemic events while under the care of the CNS team. CNSs are effective in helping patients and providers achieve enhanced management of diabetes during hospital admissions.