Doctor of Nursing Practice
Post Master's DNP Completion
Year Degree Awarded
Month Degree Awarded
Katharine Green, PhD, CNM, FACNM
Background: Those diagnosed with gestational diabetes mellitus have a high chance of developing diabetes in the years following delivery. People who live with undiagnosed diabetes are at high risk for developing cardiovascular disease, eye, kidney and nerve damage. Glucose tolerance testing should be completed four to twelve weeks after delivery in anyone diagnosed with GDM, and even if screening is negative, it should be repeated every one to three years after.
Purpose: In a chart audit of patients who delivered Fall 2020 at the facility, only 15% of patients with GDM were compliant with completing a 2-hour oral glucose tolerance test (OGTT) in the postpartum period. The aim of this project was to increase completion of postpartum glucose screening to 50% for women four to 12-weeks postpartum over a 90-day period.
Methods: This project was completed by tracking postpartum patients diagnosed with GDM in pregnancy, from October 2021 through December 2021, to assess the effect of the proposed interventions on improving screening rates at an urban medical center in Massachusetts.
Results: In the 257 women delivered during this time, 26 patients screened positive for GDM (10%) during their pregnancy. An educational session was given on postpartum screening after which staff awareness of screening recommendations improved and the 2-hour OGTT rates increased from 15% to 55.5%. There was also an increase in completed postpartum visits in GDM patients from 60% to 89% from the beginning of the project.
Conclusion: GDM screening increased by 40.5% at the end of the 90 days. All of those who were screened and had abnormal 2-hour OGTTs were referred appropriately for follow up care. An integral component of quality improvement as evident by this project is the importance of team engagement.
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