Doctor of Nursing Practice (DNP) Projects

Access Control

Open Access

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Embargo Period

7-6-2016

Degree Program

Doctor of Nursing Practice

Degree Track

Family Nurse Practioner

Year Degree Awarded

2016

Month Degree Awarded

May

Keywords

metabolic syndrome, Metabolic Syndrome Time Tool, abdominal obesity, elevated fasting plasma glucose level, hypertension, lifestyle management

Advisor

Jean DeMartinis

DNP Project Chair

Jean DeMartinis

DNP Project Member Name

Gabrielle Abelard

Abstract

Metabolic syndrome plays a vital role in present-day primary care. The ICD-10 diagnostic coding for this set of symptoms more comprehensively identifies patients with increased risk of cardiovascular events and comorbidities. Metabolic syndrome affects one-third of adults in the US and is defined as the presence of three of the following characteristics: abdominal obesity, hypertension, elevated triglycerides, low high-density lipoprotein, and elevated fasting plasma glucose. Proper screening for metabolic syndrome can identify complex patients before conditions like hypertension or type II diabetes develop. Management of metabolic syndrome emphasizes prevention and prioritizes lifestyle modifications as first-line treatment. Despite strong evidence supporting the use of metabolic syndrome as a key diagnostic code, it is not being routinely identified and documented in primary care. Moreover, without proper screening, identification, and coding for metabolic syndrome in primary care, management and lifestyle modifications may not be initiated in a timely way or at all. This shows evidence of the large gap between what we know about metabolic syndrome and how to identify it and what is actually happening in primary care. Purpose: To address this gap, a DNP project was implemented at two primary care sites. Its purpose was to increase primary care provider knowledge, identification, and ICD-10 coding of metabolic syndrome, leading to better office visit follow-up and enhanced patient outcomes. Toolkit: A toolkit was developed based on the 2009 American College of Preventive Medicine Metabolic Syndrome Time Tool and accompanying verbal presentation with a PowerPoint. The intervention was provided live at two primary care sites to healthcare staff, including providers (NP, PA, MD) and nurses (RN, LPN). Outcomes: Valuable data were obtained regarding enhancement of provider knowledge and perceptions of metabolic syndrome, as well as their engagement with and use of the toolkit. Conclusion: Use of metabolic syndrome as a key ICD code is supported by strong evidence, primary care providers are amenable to its use, yet remain slow to adapt it into their medical records systems. Further investigation in this area is needed.

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