Abstract
Purpose: The prevalence of type 2 diabetes has reached a global epidemic, and urgent action is required to improve its management. The World Health Organization has identified adherence to clinical practice guidelines as an integral aspect of reducing the impact of diabetes. This quality improvement project aimed to improve provider adherence to the American Diabetes Association Standards of Medical Care clinical guidelines.|Background: Managing such a prominent medical condition is an essential role of a primary care provider as this is where more than 80% of adults with diabetes receive their care.|Sample/Setting: Nurse Practitioners working in a rural clinic in Washington.|Methods: The Nurse Practitioners completed an anonymous Likert survey pre-and post-implementation to determine knowledge of the American Diabetes Association (ADA) guidelines, familiarity with urine albumin-to-creatinine ratios (ACR), as well as ease of project implementation, and continued use. The nurse practitioners were provided education on the Alphabet Strategy and were encouraged to analyze each aspect of the guideline with each patient with type 2 diabetes.|Results: There were not any patients that had an ACR completed in the 12 months prior to the project. After the project, 59% had an ACR ordered and the remaining 41% declined. The ACR was completed in 30% of patients.|Conclusion: The providers at this clinic were transparent about not referring to the ADA guidelines or completing ACRs prior to the project. After the project, the survey indicated the providers felt more comfortable with the ADA guidelines, as evidenced by an improvement rate of 30% of patients having completed an ACR which aided in earlier detection of kidney disease. The survey also revealed that the Alphabet Strategy helped manage type 2 diabetes and will continue to be referenced in the future.