Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
of MI in the intervention. In order to provide optimum care for
Hispanic patients at the Reading location practices, a bilingual
(English/Spanish) and bicultural nurse with experience providing
care to Hispanic patients is working at that site.
Intervention Implementation Tracking:
To ensure consistency of the intervention and reproducibility of the
results several strategies are utilized.
1) The NCM is based on a standardized curriculums developed by
the investigators prior to implementation of the study. The
curriculum addresses management of blood glucoses, hypertension,
hyperlipidemia, and depression, and is based on the American
Diabetes Association’s Clinical Practice Recommendations, and the
Institute for Clinical Systems Improvement (ICSI) guidelines.
Regular supervision and feedback on NCM is provided by a qualified
physician and nurse team who dialogue with the nurses, review
taped clinical sessions, and observe clinical interventions.
2) The use of MI is promoted through a standardized ongoing MI
training curriculum, which involves weekly sessions on relevant
topics and a trained MI therapist’s review of nurse performance
through audiotaped patient sessions. This provides a level of
structure and standardization that guides the nurse case managers
in implementing new skills and strengthen the integrity of the MI
component of the intervention.
Analysis:
Descriptive statistics were used to analyze baseline data. Zero
percent of participants were at goal as compared to 7% nationally.
Daily journaling was used by nurses to document their role in
implementing the NCM/MI intervention. At six months, a series of
focus groups were conducted to evaluate patient response to the
intervention. These interviews were taped, coded, and content
analyzed by a team of researchers with expertise in qualitative
methods.
Study outcomes:
The primary study outcomes are percent of patients reaching goal
HbA1c, BP, LDL, and percent of patients at goal for all three
parameters. Important secondary outcomes include number of
patients with depression as measured by the CES-D tool, process
measures (% receiving eye exams, foot exams, etc.), costeffectiveness
and psychological/behavioral outcomes of the
intervention.
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