Dissertation
Reduction of compliance barriers in uninsured women with gestational diabetes mellitus
Doctor of Nursing Practice (D.N.P.), Drexel University
18 Mar 2025
DOI:
https://doi.org/10.17918/etd-7136
Abstract
Gestational Diabetes Mellitus (GDM) is a common complication of pregnancy with an increased rate of associated complications including increased risk of pre-eclampsia, macrosomia, and operative delivery. Women with GDM are managed in the outpatient setting with diet and lifestyle modification, along with fingerstick glucose testing. Compliance with fingerstick monitoring is a valuable clinical tool for monitoring glycemic control. Multiple barriers have been cited in evidence-based research, with financial barriers being a common theme, especially in women of color, without medical insurance and lower socioeconomic status. A quality improvement project was designed to identify and provide eligible patients with free glucose testing supplies from the diagnosis of GDM to the delivery of their pregnancy. The project aimed to reduce financial barriers to compliance and assess whether reducing financial constraints would improve testing compliance. The project was implemented over a 6-week pilot period, and the project team included the outpatient staff of care providers, nursing, and medical technicians. During the project, the compliance rates for glucose testing were calculated weekly for a sample of 19 patients, including the average compliance rate per patient and the mean for the entire sample. During the 6-week pilot, the testing compliance rate of the sample increased from 34% to 79%, respectively. The project results demonstrated improved glucose testing adherence with improved access to testing supplies in an uninsured population. Future project goals may include review of maternal glucose control with improved testing adherence and evaluation of delivery and neonatal data to assess for improved outcomes with improved glucose testing compliance.
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Details
- Title
- Reduction of compliance barriers in uninsured women with gestational diabetes mellitus
- Creators
- Kristin M. Kelly
- Contributors
- Barbara Ruth Osborne (DNP Chair) - Drexel University, Nurse Practitioner Master of Science in Nursing (MSN)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Nursing Practice (D.N.P.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- 48 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Doctoral Nursing; Nursing (Graduate); College of Nursing and Health Professions; Drexel University
- Other Identifier
- 991014632536304721