Type 2 Diabetes Mellitus Clinical Trial
Official title:
Effectiveness of Implementing Nursing Care Plans Based on Scientific Methodology in Improving Metabolic and Blood Pressure Control of Type 2 Diabetes Mellitus Patients.
Background: Nurses in clinical practice implement care to patients with Type 2 diabetes
mellitus (DM2) in order to maintain normal blood glucose readings, promote weight loss and
provide nutrition counseling to improve metabolic and blood pressure control. Because many
disciplines contribute to patient's health outcomes, it is important to distinguish how
nurses contribute to patient care and the achievement of health outcomes and the differences
between the use or not the classification of Nursing Diagnoses, and the Nursing
Interventions Classification (NIC) in clinical practice settings.
Methods: Prospective observational study with 2-year follow-up to assess the effect of
Nursing Care Plans based on Scientific Methodology (NCPSM) on changing the control
parameters in routine clinical practice conditions.
Settings: 31 Primary care centers in northeastern urban area of Madrid (Spain). Subjects:
24,124 DM2 patients (full universe).
The computerized clinical record system (CCR) form for primary care of the Madrid Health
Service was used as the data source. NCPSM was identified by clinical records of NANDA and
NIC nursing taxonomies, and were defined as nursing care based on the following three
criteria:
Criterion 1.- A patient's CCR must register valuation data based on Marjory Gordon
"functional pattern" in at least the following areas:
- Health perception
- Nutritional-metabolic
- Activity-exercise. Criterion 2.- The problems identified and the proper management of
treatment will be described using coded diagnoses with NANDA.
Criterion 3.- The nursing interventions carried out by standardized language will be
registered according to the NIC taxonomy.
Eligibility criteria for patients were: older than 30 years of age, with previously
diagnosed diabetes (cardinal clinical, plus random blood glucose >200 mg/dl or oral glucose
of >200 mg/dl at 2 h, twice, or plasma fasting glucose of >126 mg/dl on two occasions or
being diagnosed previously, received specific treatment for diabetes) and exclusion criteria
were: gestational diabetes, patients involved in clinical trials, patients with life
expectancy of less than one year (according to clinical judgment), homebound patients.
The primary outcome was HbA1c, lipid levels, blood pressure, and BMI after 24 and 48 months
of follow-up.
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Observational Model: Cohort, Time Perspective: Prospective
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