Graduation Semester and Year

2016

Language

English

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Mary Schira

Abstract

Background: Current research indicates the efficacy of bariatric surgery (BS) in the treatment of obese Type 2 Diabetes Mellitus (T2DM) patients, but only a few actually get this treatment option. This is evident when a comparison of the prevalence of T2DM and obesity is compared to the actual number of surgeries conducted. The American Society of Metabolic and Bariatric Surgery (ASMBS) states that less than 1 % of eligible patients (general) have access to BS. The option most frequently considered to manage obesity and T2DM (i.e. lifestyle modification), is ineffective and results in weight regained in an average of 4 years. Method/Data source: The purpose of this quality improvement project was to increase provider awareness regarding BS for the treatment of obese individuals with T2DM. An evidence based protocol was implemented that included offering information and the option of BS to treat adult obese patients with T2DM. Documentation of patient education regarding BS was obtained from a random sample of medical records pre and post intervention. Results: Forty-four (44) and forty-one (41) charts were reviews pre and post intervention respectively. Pre-intervention none of the charts reviewed had evidence of documentation of BS as a treatment option. Post intervention 83% (34/41) of the charts had BS education documented. Of the patients offered the BS option 56% (19) opted for BS. Of the 44% (15) who refused, more than half (8) was due to the fear of surgery. Of note is that the diagnosis of obesity was not documented in 80% of the charts reviewed pre-intervention and post-intervention 49% of the charts reviewed did not have obesity as a listed diagnosis. Conclusion and implications: Current evidence shows BS results in significant improvement of T2DM, compared to current medical therapy with lifestyle modification. Despite this evidence, the option of BS is often not included in provider patient education. This QI project suggests that if patients are given the option more than half of the patients will consider BS as their treatment option. Based on the epidemic nature of T2DM, increased awareness is necessary among clinicians for the consideration of BS to treat obese T2DM patients, and help improve patient access.

Disciplines

Medicine and Health Sciences | Nursing

Comments

Degree granted by The University of Texas at Arlington

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