DNP 840 Post your PICOT and expand in detail on your selected patient population

For diabetic patients in a primary care clinic, does implementation of American Diabetes Association Professional Practice Committee American Diabetes Associations Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes—2022 guidelines: Medical Nutrition Therapy Interventions impact HbA1C compared to current practice over 12 weeks? My patient population is mostly lower socioeconomic individuals with little or no health insurance coverage (Edupuganti et al., 2019). A large majority are immigrants with questionable citizenship status. For example, I have Sudanese patients with limited English, and caring for them is sometimes challenging due to communication barriers. I and others use translation applications, but paid translation services are outside our budget. This clinic is a free service funded by donations, grants, and Medicaid or Medicare (Centers for Disease Control and Prevention, 2022). I have volunteered here for a few years and am still waiting to see a private insurance carrier. Many patients live in multigenerational homes whose income falls well below the poverty guidelines. Their food choices are limited as the clinic is in a desert. Hence, healthy, nutrient-dense foods are scarce. In addition, health literacy, educational levels, and access to transportation are limited. Therefore, if we reflect on Maslow’s needs theory, we realize that this population struggles with basic needs; and try as I may, those that can vote focus on essentials such as food and utilities. Unfortunately, their lack of participation in voting may reduce their probability of political change. Hence their circumstances are social determinants affect increasing their risk for adverse outcomes. Sadly, this North Texas clinic resembles many faith-based outreach programs nationwide. Its multiracial and ethnically diverse community falls within the marginalized groups discussed in previous courses (Centers for Disease Control and Prevention, 2022). The health disparities result in more significant rates of diabetes, obesity, heart disease, and hypertension. Therefore the life expectancy for patients in the clinic is much lower. These factors will ultimately affect diabetic outcomes. What is clear is that we must tailor care to reflect the individual. The MNT process has several components, many encouraging a culturally specific diet. The MNT program also suggests including a dietician, education, and support. Incorporating these factors may assist with compliance and increase positive patient outcomes.

References

Centers for Disease Control and Prevention. (2022, July 1). What is health equity? Centers for Disease Control and Prevention. https://www.cdc.gov/healthequity/whatis/index.html Edupuganti, S., Bushman, J., Maditz, R., Kaminoulu, P., & Halalau, A. (2019). A quality improvement project to increase compliance with diabetes measures in an academic outpatient setting. Clinical Diabetes and Endocrinology, 5(1). https://doi.org/10.1186/s40842-019-0084-9