Barriers to Daiy Blood Glucose Self-monitoring in Type 2 Diabetes Mellitus

Barriers to Daily Blood Glucose Self-Monitoring in Type 2 Diabetes Mellitus by Sylvain N. Tientcheu MS, Walden University, 2014 BS, Lamar University, 2010 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2018 Abstract Routine blood glucose monitoring by patients with Type 2 diabetes mellitus (T2DM) is needed for effective management of T2DM; however, 75% of monitoring logs are returned incomplete during monthly provider follow-up appointments. As a result, effective management of the patient’s medical condition is limited. To better understand the reasons for noncompliance, a quality improvement project (QIP) was initiated between July 01, 2017 and September 30, 2017, to identify barriers that prevented patients from self-monitoring of blood glucose (SMBG). No formal assessment of the patients’ responses had been done, and, as a result, the deidentified, qualitative responses from the QIP were obtained for this project. The purpose of this project was to explore barriers to SMBG and to use a literature search to identify strategies for improving compliance with SMBG. The health belief model was the framework used to guide the project. Secondary data obtained from the QIP (n = 19) were analyzed and coded. Results indicated that patients’ financial concerns, social support, emotional needs, and lack of diabetes education were the main barriers to daily SMBG. Recommendations to the providers were to consider each barrier before ordering the use and frequency of SMBG and to consider an appropriate strategy for promoting SMBG adherence. Addressing low compliance with SMBG may promote positive social change through improved T2DM management, self-care, adherence to daily SMBG and treatment, and improved patient quality of life.Routine blood glucose monitoring by patients with Type 2 diabetes mellitus (T2DM) is needed for effective management of T2DM; however, 75% of monitoring logs are returned incomplete during monthly provider follow-up appointments. As a result, effective management of the patient’s medical condition is limited. To better understand the reasons for noncompliance, a quality improvement project (QIP) was initiated between July 01, 2017 and September 30, 2017, to identify barriers that prevented patients from self-monitoring of blood glucose (SMBG). No formal assessment of the patients’ responses had been done, and, as a result, the deidentified, qualitative responses from the QIP were obtained for this project. The purpose of this project was to explore barriers to SMBG and to use a literature search to identify strategies for improving compliance with SMBG. The health belief model was the framework used to guide the project. Secondary data obtained from the QIP (n = 19) were analyzed and coded. Results indicated that patients’ financial concerns, social support, emotional needs, and lack of diabetes education were the main barriers to daily SMBG. Recommendations to the providers were to consider each barrier before ordering the use and frequency of SMBG and to consider an appropriate strategy for promoting SMBG adherence. Addressing low compliance with SMBG may promote positive social change through improved T2DM management, self-care, adherence to daily SMBG and treatment, and improved patient quality of life. Barriers to Daily Blood Glucose Monitoring in Type 2 Diabetes Mellitus by Sylvain N. Tientcheu MS, Walden University, 2014 BS, Lamar University, 2010 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2018 Dedication This doctorate project is dedicated to my dad and mom Pierre and Victorine Tientcheu who gave me the spirit and desire of higher achievement. To my wife Susan Tientcheu who continually provide me with her unconditional moral, spiritual, emotional, and financial support to keep alive the spirit and desire of higher achievement. To my children Brice, Arnold, Sonia, Dylane, Sharone, and Lovely Tientcheu who will receive and keep alive the spirit and desire of higher achievement. Acknowledgments I would like to express my deepest gratitude to my committee chair Dr. Janice Long for her unwavering guidance, support, and mentorship throughout this Doctor of Nursing Practice project, as well as to the Walden University faculties who offered me collegial guidance and support over the years: Dr. Andrea Jennings-Sanders, Dr. Diane Whitehead, and Dr. Alice Edith Conway. I would like to extend my thanks to the staff who offered support and mentorship throughout this doctorate journey.