Enhancing Workplace Wellness: A Comprehensive Approach to Sleep Apnea Screening in Onsite Health.

Background: This quality improvement project aimed to increase the screening rate for OSA in individuals aged 18 and above with obesity (body mass index [BMI] ≥30).

Methods: This quality improvement study occurred from March 2023 to August 2023 using a two-independent pre-implementation post-implementation design. The STOP-Bang Questionnaire (SBQ) was implemented during annual exams, chronic disease management visits, and Department of Transportation (DOT) physicals.

Implementation of a Prediabetes Risk Test for an Underserved Population in a Federally Qualified Health Center.

Consistent screening for prediabetes is imperative to ensure early detection and timely intervention to prevent progression to diabetes. Adopting a standardized approach such as a screening tool can streamline the screening process. This articles describes a quality improvement project conducted at a federally qualified health center to assess whether implementation of the Prediabetes Risk Test improved early detection of prediabetes in an underserved population.

Comparing satisfaction and outcomes in on-campus versus virtual education for nurse practitioner students.

This article highlights the development and implementation of interactive training experiences for graduate nursing students as part of specialty training in endocrinology. Emphasis was placed on accomplishing the shift from on-campus to virtual training while maintaining fidelity and student satisfaction. A total of 106 graduate nursing students from five cohorts submitted evaluations.

Blood Pressure Control and the Association With Diabetes Mellitus Incidence: Results From SPRINT Randomized Trial.

The SPRINT (Systolic Blood Pressure Intervention Trial) demonstrated reduced cardiovascular outcomes. We evaluated diabetes mellitus incidence in this randomized trial that compared intensive blood pressure strategy (systolic blood pressure <120 mm Hg) versus standard strategy (<140 mm Hg). Participants were ≥50 years of age, with systolic 130 to 180 mm Hg and increased cardiovascular risk.

Developing Innovative On-Campus Intensives to Enhance Distance-Based Nurse Practitioner Programs.

Background: The delivery of higher education has changed dramatically in recent years due to the shift toward distance learning, resulting in a need for creative education delivery methods. This article describes the implementation of on-campus intensives (OCIs) within a revised curricular framework for nurse practitioner (NP) students. Sequential OCIs are designed to promote role transition and professional and clinical development throughout the NP student's coursework.

Implementation of A1C Point-of-Care Testing: Serving Under-Resourced Adults With Type 2 Diabetes in a Public Health Department.

A1C point-of-care testing (POCT) paired with face-to-face education potentially improves glycemic control in under-resourced populations. In this study, A1C POCT was implemented with same-day face-to-face medication management and education for adults with type 2 diabetes in a public health department in southeastern North Carolina. The combination of POCT, medication management, and education provided together improved glycemic control and decreased clinical inertia in a setting in which access to health care is limited.

Hyperglycemia Syndromes.

Diabetes mellitus and its complications are among the leading causes of organ failure around the world. It is imperative that timely, patient-centered care is provided to avoid microvascular and macrovascular damage. People with well-controlled diabetes can live long and healthy lives through interprofessional management, emphasizing optimal, individualized care.

Development of an Innovative Endocrinology Training Program for Nurse Practitioners.

Background: Nurse practitioners (NPs) have a critical role in meeting the growing demand for health care in the current complex health care system. The use of NPs in both primary care and specialty settings is expected to rise significantly by 2025 in response to increased demands and a shortage of physician providers.

Method: The Duke University School of Nursing, with funding from the Health Resource Services Administration, has implemented the first endocrinology specialty training program for primary care NP students.

Effectiveness of Implementing Initial Education Strategies to Promote Awareness and Healthy Habits in Childhood Obesity: A Quality Improvement Project.

Background: Rising incidence and prevalence of childhood obesity and related costly health consequences suggest the need for an effective training tool at the primary care level. Evidence-based studies show how a healthy diet and physical activity help reduce the incidence of obesity.

Methods: The objective for this quality improvement project was to evaluate the effectiveness of an evidence-based educational tool in improving healthy eating and physical activity habits among overweight and obese children in a primary care setting over 3 months.

Effect of Intensive Versus Standard Blood Pressure Treatment According to Baseline Prediabetes Status: A Post Hoc Analysis of a Randomized Trial.

Objective: To determine whether the effects of intensive (<120 mmHg) compared with standard (<140 mmHg) systolic blood pressure (SBP) treatment are different among those with prediabetes versus those with fasting normoglycemia at baseline in the Systolic Blood Pressure Intervention Trial (SPRINT).

Research Design And Methods: This was a post hoc analysis of SPRINT. SPRINT participants were categorized by prediabetes status, defined as baseline fasting serum glucose ≥100 mg/dL versus those with normoglycemia (fasting serum glucose <100 mg/dL).

Diabetes Distress or Major Depressive Disorder? A Practical Approach to Diagnosing and Treating Psychological Comorbidities of Diabetes.

The presence of major depressive disorder (MDD) in people with diabetes may be up to three times more common than in the general population. People with diabetes and major depressive disorder have worse health outcomes and higher mortality rates. Diabetes distress refers to an emotional state where people experience feelings such as stress, guilt, or denial that arise from living with diabetes and the burden of self-management.

Diabetes Self-management Quality Improvement Initiative for Medically Underserved Patients.

The burden of diabetes is greater for minorities and medically underserved populations in the United States. An evidence-based provider-delivered diabetes self-management education intervention was implemented in a federally qualified health center for medically underserved adult patients with type 2 diabetes. The findings provide support for the efficacy of the intervention on improvement in self-management behaviors and glycemic control among underserved patients with diabetes, while not substantially changing provider visit time or workload.

Type 1 diabetes & cardiovascular disease.

Individuals with type 1 diabetes mellitus (T1DM) have a high risk of developing cardiovascular disease (CVD), but some risk factors can be mediated by lifestyle modification and medication. NPs should understand evidence-based management approaches to counsel patients with T1DM on appropriate self-management interventions to reduce the likelihood of CVD.

Caring for women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting reproductive-age women. PCOS causes hyperandrogenism and anovulation and increases the risk of multiple health conditions including infertility, diabetes mellitus, and cardiovascular disease. This article outlines current recommendations for diagnostic testing, treatment options, and holistic care of the woman with PCOS.

Transitioning safely from intravenous to subcutaneous insulin.

The transition from intravenous (IV) to subcutaneous (SQ) insulin in the hospitalized patient with diabetes or hyperglycemia is a key step in patient care. This review article suggests a stepwise approach to the transition in order to promote safety and euglycemia. Important components of the transition include evaluating the patient and clinical situation for appropriateness, recognizing factors that influence a safe transition, calculation of proper SQ insulin doses, and deciding the appropriate type of SQ insulin.