Type 2 Diabetes Mellitus (T2DM) poses a significant healthcare challenge, necessitating effective and efficient management strategies. Standardized Nursing Care Plans (SNCP), utilizing a common nursing language, have been proposed as a method to improve nursing data management. This study investigates the impact of SNCP, based on the North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classification (NIC), on the health outcomes of patients with T2DM, specifically focusing on metabolic control, weight management, and blood pressure regulation.
This two-year prospective study, conducted across 31 primary health care centers in Spain, involved 24,124 outpatients diagnosed with T2DM in routine clinical practice. Patient data was gathered from Computerized Clinical Records, with SNCP implementation identified through NANDA and NIC classifications. The study compared two groups: a Usual Nursing Care (UNC) group (18,320 patients) and an SNCP group (5,168 patients). Statistical analyses, including descriptive and ANCOVA methods, were employed to assess the effectiveness of SNCP.
The findings revealed that at the two-year mark, the SNCP group demonstrated improvements in most measured health parameters, with the exception of LDL cholesterol and diastolic blood pressure. After adjusting for baseline values and other statistically significant differences between the groups, a general lowering trend was observed across parameters, although statistically significant reduction was only confirmed for diastolic blood pressure. Despite this statistical significance, the clinical relevance of the adjusted diastolic blood pressure reduction was considered minimal. However, notable differences in control values for diastolic blood pressure, HbA1c, LDL-cholesterol, and Body Mass Index were more pronounced in the SNCP group, with HbA1c reaching statistical significance. Crucially, a larger proportion of patients with elevated baseline HbA1c levels (≥7%) successfully decreased their HbA1c in the SNCP group.
In conclusion, the implementation of SNCP appears to be a valuable tool in achieving glycemic control, particularly for T2DM patients with poorly managed blood sugar levels (HbA1c ≥7%). Furthermore, a slight improvement in diastolic blood pressure was noted in the SNCP group compared to the UNC group, suggesting a broader positive impact of standardized nursing care plans on diabetes management.
Trial registration: ClinicalTrials.gov NCT01482481
